Evaluating aerosol and splatter during orthodontic debonding: implications for the COVID-19 pandemic

Llandro, H.; Allison, J.; Currie, C.; Edwards, D.; Bowes, C.; Durham, J.; Jakubovics, N.; Rostami, N.; Holliday, R.

Introduction: Dental procedures often produce splatter and aerosol which have potential to spread pathogens such as SARS-CoV-2. Mixed guidance exists on the aerosol generating potential of orthodontic procedures. The aim of this study was to evaluate aerosol and/or splatter contamination during an orthodontic debonding procedure. Material and Methods: Fluorescein dye was introduced into the oral cavity of a mannequin. Orthodontic debonding was carried out in triplicate with filter papers placed in the immediate environment. Composite bonding cement was removed using a slow-speed handpiece with dental suction. A positive control condition included a high-speed air-turbine crown preparation. Samples were analysed using digital image analysis and spectrofluorometric analysis. Results: Contamination across the 8-metre experimental rig was 3% of the positive control on spectrofluorometric analysis and 0% on image analysis. There was contamination of the operator, assistant, and mannequin, representing 8%, 25%, and 28% of the positive control spectrofluorometric measurements, respectively. Discussion: Orthodontic debonding produces splatter within the immediate locality of the patient. Widespread aerosol generation was not observed. Conclusions: Orthodontic debonding procedures are low risk for aerosol generation, but localised splatter is likely. This highlights the importance of personal protective equipment for the operator, assistant, and patient.