Toggle Main Menu Toggle Search

Open Access padlockePrints

Evaluating aerosol and splatter during orthodontic debonding: implications for the COVID-19 pandemic

Lookup NU author(s): Dr Hayley Llandro, James AllisonORCiD, Dr Charlotte CurrieORCiD, David Edwards, Charlotte Bowes, Professor Justin DurhamORCiD, Professor Nicholas JakubovicsORCiD, Dr Nadia Rostami, Dr Richard HollidayORCiD



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Nature Publishing Group, 2021.

For re-use rights please refer to the publisher's terms and conditions.


Introduction: Dental procedures produce splatter and aerosol which have potential to spreadpathogens such as SARS-CoV-2. Mixed evidence exists on the aerosol generating potentialof orthodontic procedures. The aim of this study was to evaluate splatter and/or settled aerosolcontamination during orthodontic debonding.Material and Methods: Fluorescein dye was introduced into the oral cavity of a mannequin.Orthodontic debonding was undertaken with surrounding samples collected. Compositebonding cement was removed using a speed-increasing handpiece with dental suction. Apositive control condition included a water-cooled, high-speed air-turbine crown preparation.Samples were analysed using digital image analysis and spectrofluorometric analysis.Results: Contamination across the 8-metre experimental rig was 3% of the positive controlon spectrofluorometric analysis and 0% on image analysis. Contamination of the operator,assistant, and mannequin, was 8%, 25%, and 28% of the positive control, respectively.Discussion: Splatter and settled aerosol from orthodontic debonding is distributed mainlywithin the immediate locality of the mannequin. Widespread contamination was not observed.Conclusions: Orthodontic debonding is unlikely to produce widespread contamination viasplatter and settled aerosol, but localised contamination is likely. This highlights theimportance of personal protective equipment for the operator, assistant, and patient. Furtherwork is required to examine suspended aerosol.

Publication metadata

Author(s): Llandro H, Allison JR, Currie CC, Edwards DC, Bowes C, Durham J, Jakubovics N, Rostami N, Holliday R

Publication type: Article

Publication status: Published

Journal: British Dental Journal

Year: 2021

Issue: ePub ahead of Print

Online publication date: 08/01/2021

Acceptance date: 16/11/2020

Date deposited: 25/11/2020

ISSN (print): 0007-0610

ISSN (electronic): 1476-5373

Publisher: Nature Publishing Group


DOI: 10.1038/s41415-020-2503-9


Altmetrics provided by Altmetric


Funder referenceFunder name
British Endodontic Society
NIHR Doctoral Research Fellowship
NIHR Clinical Lectureship
RPGF1810/101Dunhill Medical Trust
School of Dental Sciences
Royal College of Surgeons of Edinburgh