Comparative Effectiveness of Air Purifiers and High-Volume Evacuation in Reducing Aerosols in a Real Dental Clinic Setting

Abstract

Objective To compare the effects of high-volume evacuation (HVE), the air purifier, and their combination during two types of periodontal treatment – ultrasonic scaling and root planing – on the effectiveness of control measures. Methods In a prospective, 2 × 2 × 2 factorial experimental study (N = 24 total runs), aerosol concentration increments (0.30-10.00 μm) at a fixed piont (1.0m heighet) in the clinician’s breathing zone were measured in an active dental clinic across eight intervention scenarios. Differences across conditions were analyzed using non-parametric Mann-Whitney U tests on untransformed increments, while three-way ANOVA was conducted on log-transformed concentration data to evaluate main and interaction effects. Results Three-way ANOVA confirmed a predominant main effect for the air purifier (F = 48.138, P < .001, η p 2 = 0.751), achieving a 96% median reduction efficiency (8.99-0.37 #/cm 3 , P < .001), particularly for submicron particles. Conversely, the evaluated HVE showed a non-significant 20% reduction ( P = .961). Aerosol generation was comparable between ultrasonic scaling (4.38 #/cm 3 ) and root planing (3.19 #/cm 3 , P = .495). No significant two-way or three-way interactions were observed ( P > .05). Conclusions Air purifiers demonstrated greater aerosol reduction than the evaluated HVE system under the study conditions, particularly for submicron particles. This supports a two-layered aerosol management strategy combining localized source containment with ambient filtration, optimizing environmental safety in enclosed operatories with limited natural ventilation. Clinical significance This evidence supports a two-layered aerosol management strategy: using localized HVE for source containment of large splatter, and ambient air purification for continuous clearance of escaping submicron particles to lower inhalation doses in enclosed operatories.

The authors' abstract, as published at the source. International Dental Journal, 2026 · DOI ↗