Evidence-based dentistry
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Evidence-based dentistry · Jun 2020
ReviewWhich type of personal protective equipment (PPE) and which method of donning or doffing PPE carries the least risk of infection for healthcare workers?
Data sources CENTRAL, MEDLINE, Embase and CINAHL. Study selection Controlled studies (randomised or non-randomised) that evaluated the effect of full-body PPE on healthcare workers (HCW) exposed to highly infectious diseases, assessed which method of donning and doffing PPE was associated with reduced risk of contamination or infection for HCW, and which training methods increased compliance with PPE protocols. Data extraction and synthesis Two reviewers independently screened the titles and abstracts for inclusion of studies. ⋯ Coveralls are the most difficult PPE to remove but may offer the best protection, followed by long gowns, gowns and aprons. The included studies had a high or unclear risk of bias, indirectness of evidence in simulation studies and small participant numbers. This increases the uncertainty about the estimates of effects, and it is likely that the true effects may be substantially different from the ones reported in this review.
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Evidence-based dentistry · Jun 2020
CommentA COVID-19 pandemic guideline in evidence-based medicine.
Data sources This review article scrutinised 16 clinical studies (clinical trials and observational studies) concerning coronavirus disease of 2019 (COVID-19). Additionally, 18 guidelines about the COVID-19 were reviewed and the key points were represented in this study. Study selection The review included human trials, in-vitro studies, review articles, and credible news reports about severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and COVID-19 complications, treatment guidelines, management strategies, and epidemiological features. ⋯ To keep the number of exposures to a minimum, two separate viral clearance tests taken at least 24 hours apart, were stated as necessary laboratory results before the discharge of patients with COVID-19. Conclusions The study warns about possible exponential spread of COVID-19 and proposes to adhering to tighter restrictions of social distancing. Besides the clinical guidelines presented within the study, it also encourages further up-to-date and evidence-based management guidelines for patients with COVID-19.
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Data sources Narrative reviewStudy abstract This review provides a synopsis of our understanding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease, COVID-19. The virus is shed in the nasopharyngeal and salivary secretions of carriers, and this puts dental professionals at risk for increased exposure of SARS-CoV-2. The paper summarises the current guidelines outlined by the CDC and presents the triaging protocols to identify potential carriers and how to safely limit treatment to low-risk patients.
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Evidence-based dentistry · Jun 2020
Coronavirus disease 2019 (COVID-19): challenges and management of aerosol-generating procedures in dentistry.
Data sources Experimental investigation. Study design A retrospective review to evaluate the use of a negative-pressure otolaryngology viral isolation drape (NOVID) system to reduce cross-infection through aerosol. The apparatus consists of a plastic drape suspended over the surgical field in the head and neck region with a smoke evacuator suction placed inside the chamber with an ultra-low penetrating air (ULPA) efficiency rating and a fluid suction high-efficiency particulate air (HEPA) filter compartment. ⋯ The sample size is limited to four patients and variations in the magnitude and extent of aerosol contamination needs to be investigated further before drawing any conclusions. Although unlikely, this study design did not capture the presence of aerosol/droplets in the air within the operating room which may follow removal of the isolation drape system or from exposed surgical instruments. Notwithstanding the limitations of the design, negative-pressure aspiration of air under a chamber barrier is likely to minimise the contamination from aerosol and droplet during endonasal and transoral surgery.
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Evidence-based dentistry · Jun 2020
CommentHow can we reduce the risks of SARS-CoV-2 (COVID-19) for dentists and their patients?
Design Special report. Study population This paper presented a report about the experience of the oral and maxillofacial surgeons (OMS) of Peking University School and Hospital of Stomatology, during the COVID-19 (SARS-CoV-2) pandemic. ⋯ The authors offer some methods of trying to protect oro-maxillofacial surgeons, using an algorithm of diagnosis and classifying the risk of contamination and the materials required in order to avoid it. Conclusions In conclusion, the authors suggest the use of the algorithm for patient admission during the COVID-19 outbreak.