Influence of flow rate and different size of suction cannulas on splatter contamination in dentistry: results of an exploratory study with a high-volume evacuation system

Objectives SOPs recommend high-volume evacuation (HVE) for aerosol-generating procedures (AGPs) in dentistry. Therefore, in the exploratory study, the area of splatter contamination (SCON in %) generated by high-speed tooth preparation (HSP) and air-polishing (APD) was measured when different suction cannulas of 6 mm diameter (saliva ejector (SAE)), 11 mm (HC11), or 16 mm (HC16) were utilized versus no-suction (NS). Materials and methods Eighty tests were performed in a closed darkened room to measure SCON (1m circular around the manikin head (3.14 m 2 ) via plan metrically assessment through fluorescence technique. HSP (handpiece, turbine (Kavo, Germany)) or APD (LM-ProPower TM (Finland), Airflow®-Prophylaxis-Master (Switzerland)) for 6 min plus 5 s post-treatment were performed either without suction or with low-flow (150 l/min for SAE) or high-flow rate (250 l/min/350 l/min for HC11/HC16) suction. All tests were two-tailed ( p ≤0.05, Bonferroni corrected for multi-testing). Results Irrespective the AGP, SCON was higher for NS (median [25th; 75th percentiles]: 3.4% [2.6; 5.4]) versus high-flow suction (1.9% [1.5; 2.5]) ( p =0.002). Low-flow suction (3.5% [2.6; 4.3]) versus NS resulted in slightly lower but not statistically significantly lower SCON ( p =1.000) and was less effective than high-flow suction ( p =0.003). Lowest contamination values were found with HC16 (1.9% [1.5; 2.5]; p ≤0.002), whereat no significant differences were found for HC11 (2.4% [1.7; 3.1]) compared to SAE ( p =0.385) or NS ( p =0.316). Conclusions Within study’s limitations, the lowest splatter contamination values resulted when HC16 were utilized by a high-flow rate of ≥250 l/min. Clinical relevance It is strongly recommended to utilize an HVE with suction cannulas of 16mm diameter for a high-flow rate during all AGPs and afterwards also to disinfect all surface of patients or operators contacted.