Aerosol generation and mask efficacy in particle protection during removal of composite attachments by a high-speed handpiece in clear aligners

Abstract Aerosol generation of respirable-fine particles during dental procedures with a high-speed handpiece represents a potential source of occupational particle exposure. Although removal of composite attachments in clear aligner therapy is frequently performed in clinics, its potential to generate aerosols remain underrecognized. This study aimed to quantify airborne particles generated by high-speed removal of composite attachments for clear aligners in a manikin model. Furthermore, the efficacy of three respiratory protection methods in reducing particle penetration was compared: a surgical mask alone (SM), a soft-silicone mask fitter combined with a surgical mask (SM + MF), and an N95 respirator (N95). Particle concentrations in the ambient environment during the high-speed removal of attachments were observed predominantly in the submicron size range of 0.30 to 0.99 µm ( p < 0.001). Overall, the N95 respirator provided the highest level of particle reduction, followed by the SM + MF and the SM alone. For particles larger than 0.25 µm, the SM + MF demonstrated substantial filtration improvements over the standard SM. Integrating a soft silicone mask fitter improves the facial seal of a surgical mask, demonstrating potential as a practical supplementary device to help mitigate aerosol exposure.