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Strategies for preventing aerosol-generated microbial contamination in dental procedures: A systematic review and meta-analysis - 15/04/25

Doi : 10.1016/j.ajic.2025.02.001 
Ravinder S. Saini, PhD a, Rayan Ibrahim H. Binduhayyim, PhD a, Seyed Ali Mosaddad, DDS b, c, , Artak Heboyan, PhD d,
a Department of Dental Technology, COAMS, King Khalid University, Abha, Saudi Arabia 
b Department of Research Analytics, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, India 
c Department of Conservative Dentistry and Bucofacial Prosthesis, Faculty of Odontology, Complutense University of Madrid, Madrid, Spain 
d Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Yerevan, Armenia 

Address correspondence to Seyed Ali Mosaddad, Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid (UCM), Plaza Ramón y Cajal s/n, 28040 Madrid, Spain or Artak Heboyan, Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan 0025, Armenia.Department of Conservative Dentistry and Buccofacial Prostheses, Faculty of Odontology, University Complutense of Madrid (UCM), Plaza Ramón y Cajal s/n, 28040 Madrid, Spain or Artak Heboyan, Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar HeratsiStr. Koryun 2Yerevan0025Armenia

Resumen

Background

Aerosol generation in dental practice is a significant concern in infection control. This study aimed to investigate the strategies for controlling and preventing aerosol-generated microbes during dental procedures.

Methods

A comprehensive literature search was performed using Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines through electronic databases (PubMed, ScienceDirect, Cochrane Library, Google Scholar, and Scopus) for studies reporting interventions, including mouthwash and suction devices, that were effective against pathogens generated during dental procedures. Predefined criteria identified eligible studies. Pooled efficacy was estimated using RevMan 5.4's random-effects model.Quality assessments were performed using RoB-2.0 and the Robvis web application.

Results

This systematic review and meta-analysis included 19 papers. Cetylpyridinium chloride, chlorhexidine, chlorine dioxide, hydrogen peroxide, botanical medicines, and suction devices are the most used dental therapies to minimise microbial contamination. Overall, these treatments showed success with a pooled effectiveness of -46.64 (95% CI: -60.89 to -32.38, I2=100%, p<0.00001).

Conclusions

This study emphasises the need for a multifaceted approach that uses antiseptic mouthwash and suction devices to reduce cross-contamination and infection transmission during aerosol-generated dental procedures, safeguarding patients and dental workforce.

El texto completo de este artículo está disponible en PDF.

Highlights

Dental aerosols impart a significant danger of spreading infections to patients and healthcare professionals.
Antiseptic mouthwashes (CHX, CPC, ClO₂, H₂O₂, PI) significantly decrease microbial contamination in aerosols.
High-volume evacuation (HVE) suction devices substantially reduce aerosol propagation and infection risk.
A meta-analysis validates a 46.64% decrease in microbial burden by integrated preventative strategies.
Standardised protocols and advanced air purification equipment are necessary for infection control in dental clinics.

El texto completo de este artículo está disponible en PDF.

Key Words : Aerosols, Respiratory aerosols and droplets, Air microbiology, Indoor air quality, Dental offices, Dentistry


Esquema


 Funding/support: The authors extend their appreciation to the Deanship of Research and Graduate Studies at King Khalid University for funding this work through Review Article Project under grant number RA.KKU/7/45
 Conflicts of interest: None to report.
 Ethics approval and consent to participate: Not applicable.
 Consent for publication: Not applicable.
 Availability of data and materials: The data presented in this study are available on request from the corresponding author.


© 2025  The Authors. Publicado por Elsevier Masson SAS. Todos los derechos reservados.
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P. 638-647 - mai 2025 Regresar al número
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