- 學位論文
牙科治療時產生生物氣溶膠之研究
The study of bioaerosol assessment under different dental treatment procedures
摘要
由於新型冠狀肺炎可能由牙科各項處置時，所產生的生物氣溶膠(bioaerosol)傳播病毒，本研究設計探討監測，在不同牙科處置情況下，生物氣溶膠傳播與距離的關聯性，並進一步評估使用口外吸引裝置，是否可以有效減少生物氣溶膠的傳播。在某醫療院所牙科診間，於距離牙科治療椅1.5公尺內，選定診療椅左側地面的O（病患下頷處）、A（水平距離0.5公尺）、B（水平距離1公尺）、C（水平距離1.5公尺）四個採樣點分別放置胰化酪蛋白大豆瓊脂培養基，按治療的類型分為超音波洗牙治療和牙科高速手機治療兩個組別，暴露時間分別各為3小時15分鐘，且重複進行三次收集實驗樣本以及未進行牙科治療操作的環境背景值。另在同樣實驗條件下，分別在超音波洗牙機和牙科高速手機操作下，使用口外吸引裝置，採集生物氣溶膠樣本，並進行培養分析。研究結果在超音波洗牙治療和牙科高速手機治療過程中，不論於採樣點O、A、B和C皆可收集到生物氣溶膠樣本。研究採樣點O、A、B、C於兩種牙科治療操作時，兩組分別和環境背景值相比時的p值皆為0.0369，皆具有統計學上的意義。進一步分析超音波洗牙治療和牙科高速手機治療兩個組別中，在不同距離下的生物氣溶膠樣本皆具有統計意義，其p值依序分別為0.0216和0.0156，於統計學上也具有意義。使用口外吸引裝置之實驗中，雖然對兩組治療類型在不同距離採樣下，分別可減少最低19.3%至最高39.67%的生物氣溶膠，但各組皆未具有統計學上之差異。總結在牙科高速手機和超音波洗牙機的治療處置過程中，皆會在不同距離下產生生物氣溶膠，而使用口外吸引裝置雖可減低氣溶膠量，但仍待進一步研究探討其使用方式及功效，在當今嚴峻疫情下，此研究結果可提供臨床場域作為醫療防護之參考。
並列摘要
Due to the possible risk of SARS-Co-2 transmission via bioaerosol from dental treatments, this article aims to investigate the relationship between bioaerosol transmission and distance under different dental treatment conditions. Furthermore, to assess whether the use of an external suction device would effectively reduce the bioaerosol transmission. Four Tryptic Soy Agar (TSA) were placed respectively on the floor of the left side of the patient. Sampling points O (At chin of the patient), A (0.5 meters), B (1 meter), and C (1.5 meters) were spaced in 0.5 meters’ intervals for 1.5 meters. According to the treatment type, it was divided into two groups: ultrasonic scaling and dental handpiece treatment. The experiments were repeated triply to collect samples and the background values under an exposure time of three hours and fifteen minutes. With the same experimental conditions, the external suction device was introduced into the design and the bioaerosol samples were collected from dental treatments for culture analysis. Significant differences were found when comparing both the ultrasonic scaler group and the dental handpiece group between sampling points O, A, B, and C to their background values individually (p-value = 0.0369). Furthermore, the sample collection was also analyzed separately in the ultrasonic scaler group and dental handpiece group at different distances. The p-value of each group was 0.0216 and 0.0156 which lead to significant outcomes. With the use of extraoral suction devices, although there were results from a 19.3% to 39.67% reduction of bioaerosol in all groups, still, there were no statistical differences between all distance groups in the utilization of EOS. Bioaerosols are generated during both dental treatment procedures in different sampling points by using dental handpieces and ultrasonic scalers. Although the use of external suction devices can reduce the number of bioaerosols, further research is required to elucidate their instruction and efficacy. Finally, during the COVID-19 pandemic, the results of this study can be seen as a reference for bioaerosol protection under aerosol generating procedures in order to secure a promising dental environment.