Graduation Date

Fall 12-17-2021

Document Type


Degree Name

Master of Science (MS)


Medical Sciences Interdepartmental Area

First Advisor

Meenakshi Vishwanath

Second Advisor

Chandran Achutan

Third Advisor

Thomas M. Petro

Fourth Advisor

Greg G. Oakley


Introduction: Aerosols can harbor active viruses, including SARS-CoV-2, making it vital that clinical protocols implemented in the orthodontic office be based on which procedures produce aerosols. Research shows that various procedures in the field of orthodontics generate aerosols, however, there is a lack of consensus as to which procedures should be deemed aerosol-generating procedures (AGPs). The current study aimed to better understand aerosol production of various orthodontic procedures. Methods: Orthodontic procedures were performed in a closed-room dental operatory on acrylic teeth mounted onto a dental manikin. Procedures performed included: debonding, bonding, and repositioning of one bracket. Variations introduced included: high-speed handpiece (HS) with and without water coolant (WC), slow-speed handpiece (SS), high-volume evacuation (HVE), local exhaust ventilation unit (LEV), water spray/water stream, and clinician performing the procedure. A total of 15 procedures were repeated three times. An optical particle counter measured particle counts produced by each procedure. Results: Statistically significant (pConclusion: Orthodontic AGPs that can be considered high risk for spreading airborne viruses include debonding-HS without WC and repositioning-HS without WC. Low-risk procedures (non-AGPs) include debonding-SS, repositioning-HS/SS with WC, and bonding. WC has a dampening effect on AGPs. Use of HVE may be effective in reducing splatter but does not reduce aerosolized particles. When possible, LEV + HVE should be used next to the patient while performing AGPs to reduce risk of spreading airborne viruses.

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