First-of-its-Kind Study Reveals Splatter Patterns in Oral Surgery

The University of Minnesota School of Dentistry has conducted a first-of-its-kind study delving into the patterns of splatter contamination resulting from rotary instruments and irrigation during oral surgery. 

Published in Clinical Oral Investigations, the study marks a crucial milestone in understanding splatter dynamics during oral surgery procedures, offering key insights for enhancing safety measures for both providers and patients.

Experimental Setup and Key Findings

The study, carried out on patient simulators in the university’s Oral and Maxillofacial Surgery operatories, simulated the surgical extraction of four molars. Different combinations of operations, including saline with a self-irrigating drill and hydrogen peroxide with both self-irrigating and hand irrigation drills, were tested. A total of 52 procedures were completed, with splatter collected on glass fibre prefilters for analysis under UV light.

Key findings of the study include:

• Splatter Patterns: The most significant splatter occurred on the patient’s chest, followed by the assistant’s face shield. Operator face shields, face masks, and the operatory’s corner were also affected.
• Irrigant Impact: The study highlighted a marginally significant difference between assistant irrigation and self-irrigating drills. Notably, using hydrogen peroxide as an irrigant, instead of saline, increased the area of droplet splatter.

Implications for Clinical Practice

Rachel Uppgaard, a clinical associate professor in the School of Dentistry and the lead author, emphasized the importance of evidence-based decisions in clinical practice. She stated, “To finally have evidence on the impact of our use of irrigation is very important for the future of our field.”

While hydrogen peroxide rinses have been used as a pre-procedural rinse during the COVID-19 pandemic, this study introduces a novel perspective. It suggests that hydrogen peroxide may not be a suitable solution, as it enhances the risk of spreading droplets when used as an irrigant.

Boyen Huang, an associate professor in the School of Dentistry and co-author, expressed concerns about the potential shift in pre-existing ideas regarding the use of hydrogen peroxide to prevent COVID-19 in patient clinics.

Given the high splatter levels on the operator and assistant’s face shields, the study suggests the continued use of face shields as part of personal protective equipment (PPE) in oral surgery.

Future Directions and Concluding Thoughts

The authors propose further studies to explore the effects of irrigants and irrigation methods on viral load and surface stability of viruses. Additionally, testing of frequently-touched locations is recommended.

The University of Minnesota School of Dentistry, as the state’s only dental school, remains dedicated to advancing health through scientific discovery, innovative education, and high-quality care for communities.

About the School of Dentistry

The University of Minnesota School of Dentistry plays a pivotal role in advancing health through scientific discovery, innovative education, and providing high-quality care for communities. 

As the state’s sole dental school, it educates the next generation of oral health professionals and serves as a resource to five states for dental education and consultation. Notably, 72 percent of Minnesota’s practicing dentists are graduates of the dental school, with its clinics handling over 156,000 patient visits each year. 

For more information, visit dentistry.umn.edu.