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The "2for2" Technique: A Modified Double-Evacuation Procedure To Minimize Droplet and Aerosol Production

The document describes a "2for2" technique that utilizes a double saliva evacuator to minimize droplet and aerosol production when preparing tooth surfaces or removing adhesives. The technique exposes only one operator to risk by connecting a low-volume evacuator to the rear and tying a high-volume evacuator to the front using an elastic band. This allows droplets and aerosols to be controlled in both the front and back of the mouth using only two hands. The technique reduces risk of infection for orthodontic staff by 50% compared to a four-handed technique and can be easily applied with standard equipment.

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Benet Babu
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67 views2 pages

The "2for2" Technique: A Modified Double-Evacuation Procedure To Minimize Droplet and Aerosol Production

The document describes a "2for2" technique that utilizes a double saliva evacuator to minimize droplet and aerosol production when preparing tooth surfaces or removing adhesives. The technique exposes only one operator to risk by connecting a low-volume evacuator to the rear and tying a high-volume evacuator to the front using an elastic band. This allows droplets and aerosols to be controlled in both the front and back of the mouth using only two hands. The technique reduces risk of infection for orthodontic staff by 50% compared to a four-handed technique and can be easily applied with standard equipment.

Uploaded by

Benet Babu
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
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The “2for2” Technique: A Modified Double-Evacuation

Procedure to Minimize Droplet and Aerosol Production

FABIO CIUFFOLO, DDS, PhD*

When preparing tooth surfaces by polishing, etching, and scaling for direct or indirect bonding, 1
or when removing adhesive for debonding, orthodontists should take strict precautions to
prevent COVID-19 transmission by minimizing the production of droplets and aerosols.2,3 A
four-handed technique using low- and high-volume saliva evacuators has recently been
recommended to control droplets and aerosols,3 but this requires two operators. Here is a
“2for2” technique that utilizes a double saliva evacuator and two working hands, thus exposing
only one operator to the risk of contagion. For a video demonstration, visit
https://youtu.be/oPIvNGoC84k.

Procedure
1. Isolate the dentition to ensure a dry field.**
2. Connect the low-volume evacuator to the rear connectors.
3. Tie the high-volume evacuator to the front connector using a 5/16", 2oz orthodontic
elastic.
4. Position the front evacuator at the desired height for the upper or lower arch.
5. Use a slow-speed handpiece.
Because these materials and equipment are readily available in an orthodontic office, the
technique is inexpensive and can be applied immediately. It has the following additional
advantages:

• Droplets and aerosols are controlled in both the anterior and posterior areas of the
mouth.
• The front high-volume evacuator is flexible enough to be used on either side of the upper
or lower arch.
• The technique can be applied in other dental specialties for situations where rubber
dams cannot be used.
• Only one operator needs to be present, reducing the risk of infection to orthodontic staff
by 50%.

*Private practice, Città Sant’Angelo, Viale Matrino 124, 65013 Pescara, Italy; e-mail:
[email protected].

**NOLA Dry Field System, Great Lakes Dental Technologies, Tonawanda, NY;
www.greatlakesdentaltech.com.
REFERENCES

1. Ciuffolo, F.; Tenisci, N.; and Pollutri, L.: Modified bonding technique for a standardized and effective
indirect bonding procedure, Am. J. Orthod. 141:504-509, 2012.
2. Seto, W.H.; Tsang, D.; Yung, R.W.H.; Ching, T.Y.; Ng, T.K.; Ho, M.; Ho, L.M.; and Peiris, J.S.M.:
Effectiveness of precautions against droplets and contact in prevention of nosocomial transmission
of severe acute respiratory syndrome (SARS), Lancet 361:1519-1520, 2003.
3. Meng, L.; Hua, F.; and Bian, Z.: Coronavirus disease 2019 (COVID-19): Emerging and future
challenges for dental and oral medicine, J. Dent. Res. 99:481-487, 2020.

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