{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T01:55:08Z","timestamp":1760234108966,"version":"build-2065373602"},"reference-count":34,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T00:00:00Z","timestamp":1616544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Aerosol production represents a major concern during the majority of dental procedures. The aim of the present study is to investigate the dynamics of aerosol particles after 15 min of continuous supragingival ultrasonic instrumentation with no attempt of containment through particle count analysis. Eight volunteers were treated with supragingival ultrasonic instrumentation of the anterior buccal region. A gravimetric impactor was positioned 1 m away and at the same height of the head of the patient. Particles of different sizes (0.3\u201310 \u00b5m) were measured at the beginning of instrumentation, at the end of instrumentation (EI), and then every 15 min up to 105 min. The 0.3-\u00b5m particles showed non-significant increases at 15\/30 min. The 0.5\u20131-\u00b5m particles increased at EI (p &lt; 0.05), and 0.5 \u00b5m remained high for another 15 min. Overall, all submicron aerosol particles showed a slow decrease to normal values. Particles measuring 3\u20135 \u00b5m showed non-significant increases at EI. Particles measuring 10 \u00b5m did not show any increases but a continuous reduction (p &lt; 0.001 versus 0.3 \u00b5m, p &lt; 0.01 versus 0.5 \u00b5m, and p &lt; 0.05 versus 1\u20133 \u00b5m). Aerosol particles behaved differently according to their dimensions. Submicron aerosols peaked after instrumentation and slowly decreased after the end of instrumentation, whilst larger particles did not show any significant increases. This experimental study produces a benchmark for the measurement of aerosol particles during dental procedures and raises some relevant concerns about indoor air quality after instrumentation.<\/jats:p>","DOI":"10.3390\/ijerph18073357","type":"journal-article","created":{"date-parts":[[2021,3,24]],"date-time":"2021-03-24T15:42:19Z","timestamp":1616600539000},"page":"3357","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Experimental Evaluation of Aerosol Production after Dental Ultrasonic Instrumentation: An Analysis on Fine Particulate Matter Perturbation"],"prefix":"10.3390","volume":"18","author":[{"given":"Filippo","family":"Graziani","sequence":"first","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy"},{"name":"Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4902-7813","authenticated-orcid":false,"given":"Rossana","family":"Izzetti","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy"},{"name":"Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1949-929X","authenticated-orcid":false,"given":"Lisa","family":"Lardani","sequence":"additional","affiliation":[{"name":"Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56126 Pisa, Italy"},{"name":"Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michele","family":"Totaro","sequence":"additional","affiliation":[{"name":"Hygiene and Epidemiology Unit, Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angelo","family":"Baggiani","sequence":"additional","affiliation":[{"name":"Hygiene and Epidemiology Unit, Department of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1111\/j.1600-051X.2004.00511.x","article-title":"Atmospheric contamination during ultra-sonic scaling","volume":"31","author":"Timmerman","year":"2004","journal-title":"J. Clin. Periodontol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1016\/S0889-5406(03)00623-1","article-title":"Airborne particles produced during enamel cleanup after removal of orthodontic appliances","volume":"124","author":"Ireland","year":"2003","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1177\/2380084420982506","article-title":"Up in the Air? Future Research Strategies to Assess Aerosols in Dentistry","volume":"6","author":"Geisinger","year":"2021","journal-title":"JDR Clin. Transl. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/S1473-3099(07)70029-4","article-title":"Transmission of influenza A in human beings","volume":"7","author":"Brankston","year":"2007","journal-title":"Lancet Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"S783","DOI":"10.1098\/rsif.2009.0302.focus","article-title":"Aerosol transmission of influenza A virus: A review of new studies","volume":"6","author":"Tellier","year":"2009","journal-title":"J. R. Soc. Interface"},{"key":"ref_6","first-page":"111","article-title":"Bioaerosols and health: Current knowledge and gaps in the field of waste management","volume":"5","author":"Schlosser","year":"2018","journal-title":"Detritus"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1007\/s40506-015-0057-1","article-title":"Aerosol-Transmitted Infections-a New Consideration for Public Health and Infec-tion Control Teams","volume":"7","author":"Tang","year":"2015","journal-title":"Curr. Treat Options Infect. Dis."},{"unstructured":"Graziani, F., Izzetti, R., Lardani, L., Biancarini, M.L., and Gabriele, M. (2020). Dental Practice in the Era of Sars-Cov-2 Pandemic: A Checklist to Enhance Safety and Good Practice, Edizioni Martina. [1st ed.].","key":"ref_8"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jinf.2010.11.010","article-title":"The role of particle size in aerosolised pathogen transmission: A review","volume":"62","author":"Gralton","year":"2011","journal-title":"J. Infect."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"S39","DOI":"10.26719\/2013.19.supp1.S39","article-title":"Infection prevention and control measures for acute respiratory infections in healthcare settings: An update","volume":"19","author":"Seto","year":"2013","journal-title":"East. Mediterr. Health J."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1177\/0022034520920580","article-title":"COVID-19 Transmission in Dental Practice: Brief Review of Preventive Measures in Italy","volume":"99","author":"Izzetti","year":"2020","journal-title":"J. Dent. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1016\/j.jdent.2007.06.002","article-title":"Do contaminated dental unit waterlines pose a risk of infection?","volume":"35","author":"Pankhurst","year":"2007","journal-title":"J. Dent."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"E14","DOI":"10.1038\/sj.bdj.2010.975","article-title":"A pilot study of bioaerosol reduction using an air cleaning system during dental procedures","volume":"209","author":"Hallier","year":"2010","journal-title":"Br. Dent. J."},{"doi-asserted-by":"crossref","unstructured":"Laheij, A., Kistler, J., Belibasakis, G., V\u00e4limaa, H., and De Soet, J. (2012). Healthcare-associated viral and bacterial infections in dentistry. J. Oral Microbiol., 4.","key":"ref_14","DOI":"10.3402\/jom.v4i0.17659"},{"doi-asserted-by":"crossref","unstructured":"Volgenant, C.M.C., Persoon, I.F., de Ruijter, R.A.G., and de Soet, J.J. (2020). Infection control in dental health care during and after the SARS-CoV-2 outbreak. Oral Dis., 11.","key":"ref_15","DOI":"10.1111\/odi.13408"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"429","DOI":"10.14219\/jada.archive.2004.0207","article-title":"Aerosols and splatter in dentistry: A brief review of the literature and infection control implications","volume":"135","author":"Harrel","year":"2004","journal-title":"J. Am. Dent. Assoc."},{"doi-asserted-by":"crossref","unstructured":"Zemouri, C., De Soet, H., Crielaard, W., and Laheij, A. (2017). A scoping review on bio-aerosols in healthcare and the dental environment. PLoS ONE, 12.","key":"ref_17","DOI":"10.1371\/journal.pone.0178007"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e366","DOI":"10.1016\/j.ijid.2011.03.005","article-title":"Viral infections in workers in hospital and research laboratory settings: A comparative review of infection modes and respective biosafety aspects","volume":"15","author":"Pedrosa","year":"2011","journal-title":"Int. J. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1038\/sj.bdj.4800859a","article-title":"Microbial aerosols in general dental practice","volume":"189","author":"Bennett","year":"2000","journal-title":"Br. Dent. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1002\/j.1875-595X.2001.tb00816.x","article-title":"Bacterial aerosols in the dental clinic: A review","volume":"51","author":"Leggat","year":"2001","journal-title":"Int. Dent. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1016\/j.ajodo.2006.08.021","article-title":"A new method of assessing aerosolized bacteria generated during orthodontic debonding procedures","volume":"133","author":"Greco","year":"2008","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/02786820600664152","article-title":"Deposition and Suspension of Large, Airborne Particles","volume":"40","author":"Aluko","year":"2006","journal-title":"Aerosol Sci. Technol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2014\/859090","article-title":"Influenza Virus Aerosols in the Air and Their Infectiousness","volume":"2014","author":"Nikitin","year":"2014","journal-title":"Adv. Virol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1080\/15459620802633957","article-title":"Measurement of Airborne Bacteria and Endotoxin Generated During Dental Cleaning","volume":"6","author":"Dutil","year":"2008","journal-title":"J. Occup. Environ. Hyg."},{"unstructured":"Baron, P.A., and Willeke, K. (2001). Aerosol Measurement Principles, Techniques and Applications, John Wiley & Sons, INC.. [2nd ed.].","key":"ref_25"},{"unstructured":"Wang, C. (2005). Interface Science and Technology, Elsevier Academic Press. Chapter 4 Behavior of Aerosol Particles.","key":"ref_26"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1038\/s41586-020-2271-3","article-title":"Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals","volume":"582","author":"Liu","year":"2020","journal-title":"Nature"},{"doi-asserted-by":"crossref","unstructured":"Cagetti, M.G., Cairoli, J.L., Senna, A., and Guglielmo Campus (2020). COVID-19 Outbreak in North Italy: An Overview on Dentistry. A Questionnaire Survey. Int. J. Environ. Res. Public Health, 17.","key":"ref_28","DOI":"10.3390\/ijerph17113835"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1017\/S095026881300304X","article-title":"Quantifying the risk of respiratory infection in healthcare workers performing high-risk procedures","volume":"142","author":"MacIntyre","year":"2014","journal-title":"Epidemiol. Infect."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"670","DOI":"10.5604\/12321966.1185772","article-title":"Monitoring of airborne bacteria and aerosols in different wards of hospitals\u2014Particle counting usefulness in investigation of airborne bacteria","volume":"22","author":"Mirhoseini","year":"2015","journal-title":"Ann. Agric. Environ. Med."},{"doi-asserted-by":"crossref","unstructured":"Judson, S.D., and Munster, V.J. (2019). Nosocomial Transmission of Emerging Viruses via Aerosol-Generating Medical Procedures. Viruses, 11.","key":"ref_31","DOI":"10.3390\/v11100940"},{"doi-asserted-by":"crossref","unstructured":"Cincinelli, A., and Martellini, T. (2017). Indoor Air Quality and Health. Int. J. Environ. Res. Public Health, 14.","key":"ref_32","DOI":"10.3390\/ijerph14111286"},{"key":"ref_33","first-page":"398","article-title":"The indoor air we breathe","volume":"113","author":"Oliver","year":"1998","journal-title":"Public Health Rep."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1564","DOI":"10.1056\/NEJMc2004973","article-title":"Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1","volume":"382","author":"Bushmaker","year":"2020","journal-title":"N. Engl. J. Med."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3357\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T05:40:28Z","timestamp":1760161228000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/18\/7\/3357"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,24]]},"references-count":34,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["ijerph18073357"],"URL":"https:\/\/doi.org\/10.3390\/ijerph18073357","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2021,3,24]]}}}