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Meta-Analysis
. 2024 Apr 5;24(1):417.
doi: 10.1186/s12903-024-03996-2.

Concern about the risk of aerosol contamination from ultrasonic scaler: a systematic review and meta-analysis

Priscilla Gonçalves Lomardo  1 , Mariana Campello Nunes  1 , Patrícia Arriaga  1 , Lívia Azeredo Antunes  2 , Aldir Machado  1 , Valquiria Quinelato  3 , Telma Regina da Silva Aguiar  1 , Priscila Ladeira Casado  1
Affiliations
Meta-Analysis

Concern about the risk of aerosol contamination from ultrasonic scaler: a systematic review and meta-analysis

Priscilla Gonçalves Lomardo et al. BMC Oral Health. .

Abstract

Background: Many instruments used in dentistry are rotary, such as handpieces, water syringes, and ultrasonic scalers that produce aerosols. The spray created by these instruments can carry, in addition to water, droplets of saliva, blood, and microorganisms, which can pose a risk of infections for healthcare professionals and patients. Due to the COVID-19 pandemic, this gained attention.

Objective: The aim was to carry out a systematic review of the evidence of the scope of the aerosol produced by ultrasonic scaler in environmental contamination and the influence of the use of intraoral suction reduction devices.

Design: Scientific literature was searched until June 19, 2021 in 6 databases: Pubmed, EMBASE, Web of science, Scopus, Virtual Health Library and Cochrane Library, without restrictions on language or publication date. Studies that evaluated the range of the aerosol produced by ultrasonic scaler during scaling/prophylaxis and the control of environmental contamination generated by it with the use of low (LVE) and high (HVE) volume evacuation systems were included.

Results: Of the 1893 potentially relevant articles, 5 of which were randomized controlled trials (RCTs). The meta-analysis of 3 RCTs showed that, even at different distances from the patient's oral cavity, there was a significant increase in airborne bacteria in the dental environment with the use of ultrasonic scaler. In contrast, when meta-analysis compared the use of HVE with LVE, there was no significant difference (P = 0.40/CI -0.71[-2.37, 0.95]) for aerosol produced in the environment.

Conclusions: There is an increase in the concentration of bioaerosol in the dental environment during the use of ultrasonic scaler in scaling/prophylaxis, reaching up to 2 m away from the patient's mouth and the use of LVE, HVE or a combination of different devices, can be effective in reducing air contamination in the dental environment, with no important difference between different types of suction devices.

Keywords: Aerosols; Bioaerosol; COVID-19; Environmental contamination; SARS-CoV-2 virus; Ultrasonic scaler.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram (13) of the screening and selection process
Fig. 2
Fig. 2
Risk of bias in randomized controlled trials analyzed using the RoB 2 tool
Fig. 3
Fig. 3
Analysis 1 – Contamination of the dental environment by aerosol produced during scaling with ultrasonic, in randomized controlled studies. Primary outcome: contamination of the dental environment. Subtitle: SD: Standard deviation, CI: Confidence interval
Fig. 4
Fig. 4
Analysis 2 - Reduction in the level of aerosol contamination by comparing the use of high (HVE) and low (LVE) volume suction in randomized controlled trials. Secondary outcome: reduction in the level of contamination. Subtitle: SD: Standard deviation, CI: Confidence interval
See this image and copyright information in PMC

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