ABSTRACT
The COVID-19 pandemic revealed opportunities to improve prevention practices in healthcare settings, mainly related to the spread of airborne microbes (also known as bioaerosols). This scoping review aimed to map methodologies used to assess the implementation of portable air cleaners in healthcare settings, identify gaps, and propose recommendations for future research. The protocol was registered in the Open Science Framework and reported following the checklist provided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis - an extension for Scoping Reviews (PRISMA-ScR) statement. The search strategy was performed in five databases and one grey literature source. At the last selection phase, 24 articles that fulfilled our inclusion criteria were summarized and disseminated. Of these, 17 studies were conducted between 2020 and 2022; one of them was a protocol of a multicentre randomized controlled trial. The outcomes measured among the studies include airborne microbe counts, airborne particle concentrations, and rate of infections/interventions. The leading healthcare settings assessed were dental clinics (28%), patient's wards (16%), operating rooms (16%), and intensive care units (12%). Most of the devices demonstrated a significant potential to mitigate the impact of bioaerosols. Although some indoor air quality parameters can influence the mechanics of aerosols, only a few studies controlled these parameters in their analyses. Future clinical research should assess the rate of infections through randomized controlled trials with long-term follow-up and large sample sizes to determine the clinical importance of the findings.
Subject(s)
COVID-19 , Humans , COVID-19/prevention & control , Pandemics/prevention & control , Respiratory Aerosols and Droplets , Delivery of Health Care , Health Facilities , Randomized Controlled Trials as Topic , Multicenter Studies as TopicABSTRACT
The objective of this longitudinal clinical randomized trial was to evaluate the clinical performance of a nanofilled and a nanohybrid resin composite in Class I occlusal restorations of posterior teeth over the course of 54 months. Forty-one adolescents participated in the study. The teeth were restored with Adper Single Bond 2 (3M ESPE) and nanofilled (Filtek Z350, 3M ESPE), nanohybrid (Esthet-X, Dentsply) and microhybrid Filtek Z250 (3M ESPE) used as a control. After 54 months, the restorations were evaluated in accordance with the modified United States Public Health Service criteria. The McNemar and Friedman tests were used for statistical analysis, at a level of significance of 5%. Five failed restorations were observed during the follow-up. A change to unacceptable restoration occurred for one Esthet-X, two Filtek Z350, and two Filtek Z250 restorations, which received the clinically unacceptable score, Charlie, for both anatomic form and marginal adaptation. Secondary caries and postoperative sensitivity occurred in one Filtek Z250 and one Filtek Z350 restoration. When the five evaluation periods (baseline and six, 12, 30, and 54 months) were compared, significant differences were found in the marginal adaptation of Filtek Z250 and Filtek Z350. Significant differences in the roughness criteria (p=0.005) were also observed when the three composites were compared after 54 months (Filtek Z350 > Filtek Z250 > Esthet-X), always within clinically acceptable limits. The materials investigated showed acceptable clinical performance for Class I restoration after 54 months. Long-term reevaluations are necessary for a more detailed analysis of these composites.
