Comparing Isovac ® to High-Volume Evacuation on Aerosols and Surface Contamination During Operative Dentistry in Children: A Randomized, Controlled Trial.

Purpose: To compare the efficacy of high-volume evacuation (HVE) with a standard tip to Isovac^® in reducing contamination. The changes in biological contamination on surfaces with distance and direction from the mouth were also examined. Methods: Children aged four to 17 years requiring an aerosol-producing restorative procedure on at least two primary and/or permanent teeth were included. For part one, 60 patients (Frankl score three or four) were randomly treated using HVE or Isovac^®. After seven minutes, the patient's napkin and operator's face mask were examined for contamination. For part two, samples were collected from 15 subjects at five locations at varying distances and directions from the mouth after 12 minutes. Surface contamination was quantified using ATP bioluminescence. Results: Isovac^® significantly reduced surface contamination versus HVE but only close to the patient. Contamination decreased rapidly with distance and was not greater than the control 18 inches from the mouth horizontally. More contamination was directed vertically than horizontally. There was no increase in contamination with longer preparation time. Conclusions: Surface contamination falls rapidly with distance. Isovac^® was only superior to standard high-volume evacuation close to the mouth, which may not be clinically important for providers.