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. 2020 Oct 13;2020(10):CD013686. doi: 10.1002/14651858.CD013686.pub2

Devker 2012.

Study characteristics
Methods Trial design: CCT – split mouth (multi‐arm – but in our trial only 1 group comparing with and without HVE was used)
Location: STES dental college and hospital, Pune, Maharashtra, India
Setting: dental clinic
Language: English
Number of centres: 1
Study period: not mentioned
Funding source: not mentioned
Study protocol: not available
Participants Age: 18 to 45 years
Total number of participants: 30 (for HVE group, which is of interest for this review)
Inclusion criteria:
  • minimum of 20 healthy permanent teeth

  • absence of any dental treatment for the past 1 year

  • plaque index score and gingival index score between 1 and 2


Exclusion criteria:
  • history of any systemic disease, cardiac pacemakers or respiratory complication

  • pregnant women

  • with conditions requiring prophylactic antibiotics, prior to dental procedures and those currently on any medicines


Number randomized: 30. However, both the sides of the mouth and the order of the intervention were not randomised
Number evaluated (withdrawals/missing participants): 30
Interventions Comparison: HVE versus no HVE
Intervention:
•Group I: rinse with 0.2% chlorhexidine gluconate prior to scaling
•Group II: use of HVE during ultrasonic scaling
•Group III: rinse with 0.2% chlorhexidine gluconate prior to scaling and use of HVE during ultrasonic scaling
Group name: group II ‐ test side ‐ presence of high‐volume evacuator alone
Number of intervention groups: 1
Number randomized to intervention group: 30
Description of intervention: oral prophylaxis was done on a randomly selected side (control side) for a period of 10 minutes. After a gap of 30 minutes, high‐volume suction tip was tied to the ultrasonic scaler. Oral prophylaxis was done on the other side (test side) of the same arch with high‐volume suction for a period of 10 minutes. Following the 10‐minute sampling period, blood agar plates were taken off.
Any co‐interventions: no (2 other groups were present: Group I ‐ with preprocedural rinse and Group III ‐ with preprocedural rinse + HVE, which are not relevant to our review)
Comparator:
Group name: group II – control side ‐ absence of high‐volume evacuator
Number of control groups: 1
Number randomized to control group: 30
Outcomes Outcome name: reduction of microbial load in aerosols (blood agar plates were used to check CFU in 4 areas)
Reference point: mouth of the patient
• At 6 inches (half a foot) from reference point (operator’s nose level)
• At 6 inches (half a foot) from reference point (assistant’s nose level)
• At 12 inches (1 foot) from reference point (participant’s chest level)
• At 36 inches (3 foot) from reference point on participant’s right
Outcome measurement: CFU
Effect estimate: mean (SD not given)
Key conclusions: the results of this study showed that preprocedural rinse and high‐volume suction were effective when used alone as well as together in reducing the microbial load of the aerosols produced during ultrasonic scaling.
Notes Study authors contacted for: random sequence generation, allocation concealment, blinding of participants and personnel and study protocol. E‐mail sent on 26 July 2020 and we are yet to receive any response from the contact author.
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) High risk Sides of the mouth and the order of the intervention were not randomised
Allocation concealment (selection bias) High risk Sides of the mouth and the order of the intervention were not randomised
Blinding of participants and personnel (performance bias)
All outcomes Low risk Blinding is not possible. However, participants and personnel will not be able to alter their behaviour even if they know the received intervention.
Blinding of outcome assessment (detection bias)
All outcomes Low risk CFU is measured using digital colony counter, which is an objective method and will not be affected by blinding
Incomplete outcome data (attrition bias)
All outcomes Low risk No dropouts
Selective reporting (reporting bias) Unclear risk We are not sure of reporting selective outcomes as there is no protocol available.
Other bias Low risk None