A Systematic Review on the Efficacy of Vaporized Hydrogen Peroxide as a Non-Contact Decontamination System for Pathogens Associated with the Dental Environment
Int. J. Environ. Res. Public Health 2021, 18(9), 4748; https://doi.org/10.3390/ijerph18094748
Received: 27 January 2021 / Revised: 30 March 2021 / Accepted: 25 April 2021 / Published: 29 April 2021
Aerosol generation and a wide range of pathogens originating from the
oral cavity of the patient contaminate various surfaces of the dental
clinic. The aim was to determine the efficacy of vaporized hydrogen
peroxide fogging on pathogens related to the dental environment and its
possible application in dentistry. PICOS statement (Population,
Intervention, Comparison/Control, Outcome and Study design statement)
was used in the review. Six electronic databases were searched for
articles published from 2010 to 2020. Articles written in English
reporting vaporized hydrogen peroxide on pathogens deemed to be relevant
to the dental environment were assessed. The quality of the studies was
assessed using the risk-of-bias assessment tool designed for the
investigation of vaporized hydrogen peroxide application in dentistry. A
total of 17 studies were included in the qualitative synthesis. The
most commonly reported single bacterial pathogen was
Methicillin-resistant Staphylococcus aureus in five studies, and the
viruses Feline calicivirus, Human norovirus, and Murine norovirus were
featured in three studies. The results of the studies reporting the log
kill were sufficient for all authors to conclude that vaporized hydrogen
peroxide generation was effective for the assessed pathogens. The
studies that assessed aerosolized hydrogen peroxide found a greater log
kill with the use of vaporized hydrogen peroxide generators. The
overarching conclusion was that hydrogen peroxide delivered as vaporized
hydrogen peroxide was an effective method to achieve large levels of
log kill on the assessed pathogens. The hydrogen peroxide vapor
generators can play a role in dental bio-decontamination. The parameters
must be standardized and the efficacy assessed to perform
bio-decontamination for the whole clinic. For vaporized hydrogen
peroxide generators to be included in the dental bio-decontamination
regimen, certain criteria should be met. These include the
standardization and efficacy assessment of the vaporized hydrogen
peroxide generators in dental clinics.
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