Evaluation of Airborne Bacterial Contamination During Procedures in Oral Surgery Clinic

Kannan, Iyanar; Jimson, Sudha; Parthiban, Jkbc; Jayalakshmi, M

doi:10.13005/bpj/765

Cited by 9 publications

(31 citation statements)

References 1 publication

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“…Included studies: overview Eleven studies relating to oral surgery [34][35][36][37][38][39][40][41][42][43][44] were included following the final review (Table 1). Most (n = 4) were conducted in Japan, 35,[41][42][43] followed by India (n = 3), 34,36,37 with one each from the following countries: United Kingdom, 39 Poland, 38 Saudi Arabia 40 and Spain. 44 Publication dates ranged from 2008 to 2020, the research having been conducted up to 2019.…”

Section: Resultsmentioning

confidence: 99%

“…The majority of identified studies (n = 9) were observational, [34][35][36][37][38]40,41,43,44 in which the level of contamination and pattern of spread were two principal outcomes explored, while two studies were interventional, aimed at exploring various interventions to reduce the amount of aerosol (hence contamination) generated by oral surgery procedures. 39,42 The latter also included additional dental procedures (periodontal and restorative).…”

Section: Resultsmentioning

confidence: 99%

“…While all studies (n = 11) involved routine clinical care, the settings for oral surgery appeared mixed with three using single surgeries, 35,36,39 one involving both single and multiple-chair facilities 38 and two multiple, 34,42 while the majority did not report this information. 37,[39][40][41]43,44 Only five studies 34,37,40,41,44 formally reported staff wearing surgical level PPE involving gowns as well as masks/visors and gloves used by operator and/ or assistants and in two the same processed were indicated.…”

Section: Resultsmentioning

confidence: 99%

“…People. Five studies looked at the contamination of staff involved in the procedure, 36,37,40,41,44 all of which considered the operators (surgeons and post-graduate trainees). Three studies also included assistants.…”

Section: Resultsmentioning

confidence: 99%

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A systematic review of contamination (aerosol, splatter and droplet generation) associated with oral surgery and its relevance to COVID-19

et al. 2020

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Introduction The current COVID-19 pandemic caused by the SARS-CoV-2 virus has impacted the delivery of dental care globally and has led to re-evaluation of infection control standards. However, lack of clarity around what is known and unknown regarding droplet and aerosol generation in dentistry (including oral surgery and extractions), and their relative risk to patients and the dental team, necessitates a review of evidence relating to specific dental procedures. This review is part of a wider body of research exploring the evidence on bioaerosols in dentistry and involves detailed consideration of the risk of contamination in relation to oral surgery. Methods A comprehensive search of Medline (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, Scopus, Web of Science, LILACS and ClinicalTrials.Gov was conducted using key terms and MeSH (Medical Subject Headings) words relating to the review questions. Methodological quality including sensitivity was assessed using a schema developed to measure quality aspects of studies using a traffic light system to allow inter- and intra-study overview and comparison. A narrative synthesis was conducted for assessment of the included studies and for the synthesis of results. Results Eleven studies on oral surgery (including extractions) were included in the review. They explored microbiological (bacterial and fungal) and blood (visible and/or imperceptible) contamination at the person level (patients, operators and assistants) and/or at a wider environmental level, using settle plates, chemiluminescence reagents or air samplers; all within 1 m of the surgical site. Studies were of generally low to medium quality and highlighted an overall risk of contaminated aerosol, droplet and splatter generation during oral surgery procedures, most notably during removal of impacted teeth using rotatory handpieces. Risk of contamination and spread was increased by factors, including proximity to the operatory site, longer duration of treatment, higher procedural complexity, non-use of an extraoral evacuator and areas involving more frequent contact during treatment. Conclusion A risk of contamination (microbiological, visible and imperceptible blood) to patients, dental team members and the clinical environment is present during oral surgery procedures, including routine extractions. However, the extent of contamination has not been explored fully in relation to time and distance. Variability across studies with regards to the analysis methods used and outcome measures makes it difficult to draw robust conclusions. Further studies with improved methodologies, including higher test sensitivity and consideration of viruses, are required to validate these findings.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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A systematic review of contamination (aerosol, splatter and droplet generation) associated with oral surgery and its relevance to COVID-19

et al. 2020

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“…15 Experimental studies have consistently demonstrated that oral maxillofacial procedures generate significant amounts of aerosolized microbes, detected on surfaces up to 4 m away from the operator. 16,17 This places healthcare providers in the operating room for craniomaxillofacial (CMF) trauma procedures at particularly high risk for contracting the disease, as they involve aerosol generating medical procedures (AGMP). Assuming up to 1 in 4 of those infected with COVID-19 are asymptomatic and the prevalence of COVID-19 in the population continues to rise, the potential risk of exposure to asymptomatic carriers presenting with CMF trauma will become an even greater concern.…”

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confidence: 99%

Best Practice Guidelines for the Management of Acute Craniomaxillofacial Trauma During the COVID-19 Pandemic

DeSerres

Al-Shaqsi

Antonyshyn

et al. 2020

Journal of Craniofacial Surgery

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Coronavirus disease 2019 (COVID-19) is an infectious disease that is caused by severe respiratory syndrome coronavirus 2. Although elective surgical procedures are being cancelled in many parts of the world during the COVID-19 pandemic, acute craniomaxillofacial (CMF) trauma will continue to occur and will need to be appropriately managed. Surgical procedures involving the nasal, oral, or pharyngeal mucosa carry a high risk of transmission due to aerosolization of the virus which is known to be in high concentration in these areas. Intraoperative exposure to high viral loads through aerosolization carries a very high risk of transmission, and the severity of the disease contracted in this manner is worse than that transmitted through regular community transmission. This places surgeons operating in the CMF region at particularly high risk during the pandemic. There is currently a paucity of information to delineate the best practice for the management of acute CMF trauma during the COVID-19 pandemic. In particular, a clear protocol describing optimal screening, timing of intervention and choice of personal protective equipment, is needed. The authors have proposed an algorithm for management of CMF trauma during the COVID-19 pandemic to ensure that urgent and emergent CMF injuries are addressed appropriately while optimizing the safety of surgeons and other healthcare providers. The algorithm is based on available evidence at the time of writing. As the COVID-19 pandemic continues to evolve and more evidence and better testing becomes available, the algorithm should be modified accordingly.

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Quantitative and qualitative assessment of microbial aerosols in different indoor environments of a dental school clinic

et al. 2021

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In the indoor environment of dental clinics, dental staff and patients are exposed to various types of infectious agents transported by aerosols and particles, generated during dental procedures, promoting an increased risk of cross-infection. The aim of this study was to determine the levels and diversity of microbial aerosol in relation to particle load in five different departments of a dental school clinic. The air samples were collected by an active single-stage Andersen sampler during the treatment procedure. The mean concentrations of airborne bacteria were in the range of 52-1030 and 8-844 CFU/m 3 at the distances of 0.5 and 2 m, respectively. Bacterial aerosols in pediatric, endodontics, and restorative wards and fungal aerosols in all the sampling wards were significantly higher at the distances of 0.5 m. The dominant bacteria and fungi were identified as Micrococcus, Bacillus, Streptococcus, Staphylococcus, Penicillium, Cladosporium, Aspergillus, Rhizopus, and Alternaria. The positive associations were also obtained between bacteria and fungi levels and particulate matter (PM) concentrations.

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Evaluation of Airborne Bacterial Contamination During Procedures in Oral Surgery Clinic

Cited by 9 publications

References 1 publication

A systematic review of contamination (aerosol, splatter and droplet generation) associated with oral surgery and its relevance to COVID-19

A systematic review of contamination (aerosol, splatter and droplet generation) associated with oral surgery and its relevance to COVID-19

Best Practice Guidelines for the Management of Acute Craniomaxillofacial Trauma During the COVID-19 Pandemic

Quantitative and qualitative assessment of microbial aerosols in different indoor environments of a dental school clinic

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