Izincomo zephrothokholi ye-IAOMT yokususwa kwe-amalgam zaziwa njenge-Safe Mercury Amalgam Removal Technique (SMART). Qaphela ukuthi i-SMART yethulwa njengeqoqo lezincomo. Ochwepheshe abanamalayisense kufanele basebenzise ukwahlulela kwabo maqondana nezindlela ezithile zokwelashwa abazisebenzisayo emikhubeni yabo. Izincomo ze-SMART protocol zifaka phakathi izinyathelo ezilandelayo, ezibalwe lapha ngocwaningo lwesayensi:
Izincomo ze-IAOMT ephephile zokususa umthetho olandelwayo zisanda kuvuselelwa ngoJulayi 19, 2019. Futhi, ngoJulayi 1, 2016, izincomo zephrothokholi ye-IAOMT zaqanjwa kabusha ngokusemthethweni njenge-Safe Mercury Amalgam Removal Technique (SMART), kanye nesifundo sokuqeqeshelwa odokotela bamazinyo be-IAOMT ukuze kuqinisekiswe ku-SMART kwaqalwa.
Konke ukubuyiswa kwe-amalgam yamazinyo kuqukethe cishe i-50% ye-mercury,1 futhi imibiko nocwaningo kuyahambisana ukuthi lokhu kufakwa kukhipha imiphunga ye-mercury.2-16
Ucwaningo lwesayensi lukhombisa ukuthi i-dental mercury amalgam iveza ochwepheshe bamazinyo, abasebenzi bamazinyo, iziguli zamazinyo, kanye / noma imibungu ekukhishweni komphunga we-mercury, i-mercury equkethe izinhlayiya, kanye / noma ezinye izinhlobo zokungcola kwe-mercury.4-48
Ngaphezu kwalokho, umusi we-mercury waziwa ukuthi uzokhishwa ekugcwalisweni kwamazinyo ama-mercury amalgam ngamazinga aphezulu ngesikhathi sokuxubha, ukuhlanza, ukugedla kwamazinyo, ukuhlafuna, njll.5, 14, 15, 24, 30, 49-54 futhi i-mercury yaziwa futhi ukuthi izokhishwa ngesikhathi sokubekwa, ukufakwa esikhundleni, nokususwa kokugcwaliswa kwamazinyo kwe-zamazinyo.2, 25, 28, 29, 32, 36, 41, 45, 46, 55-60
Isebenzisa ubufakazi besayensi obutholakalayo, i-IAOMT ithuthukise izincomo zokuphepha ezibanzi zokususwa kokugcwaliswa okukhona kwamazinyo kwe-mercury zamazinyo, kufaka phakathi izindlela zokuvikela eziningiliziwe ezizosetshenziselwa inqubo. Izincomo ze-IAOMT zakhele phezu kwamasu wendabuko aphephile okususa i-amalgam njengokusetshenziswa kwamamaski, ukunisela ngamanzi, kanye nokudonswa kwevolumu ephezulu ngokulekelela lawa macebo ajwayelekile ngezindlela eziningi zokuzivikela, isidingo sazo esisanda kutholwa ocwaningweni lwesayensi.
- Isihlukanisi se-amalgam kufanele sifakwe kahle, sisetshenziswe, futhi sigcinwe ukuqoqa imfucumfucu ye-mercury amalgam ukuze ingakhishelwa ukungcola okuvela ehhovisi lamazinyo.25, 61-73
- Igumbi ngalinye lapho kususwa khona ukugcwaliswa kwe-mercury kumele kube nokuhlunga okwanele endaweni,29, 74-76 okudinga uhlelo lokuhlunga umoya oluyivolumu ephezulu (njenge-vacuum yomlomo yomthombo we-aerosol) okwazi ukususa umusi we-mercury kanye nezinhlayiya ze-amalgam ezikhiqizwe ngesikhathi kususwa ukufakwa okukodwa noma ngaphezulu kwe-mercury.45, 77
- Uma kunokwenzeka, amafasitela kufanele avulwe ukunciphisa inani le-mercury emoyeni.29, 77-79
- Isiguli sizonikezwa i-slurry yamalahle, i-chlorella, noma i-adsorbent efanayo yokuhlanza nokugwinya ngaphambi kwenqubo (ngaphandle kokuthi isiguli sinqabe noma kunezinye iziphikiso ezenza lokhu kungafanele emtholampilo).77, 80, 81
- Izingubo zokuvikela nezembozo zikadokotela wamazinyo,25, 45 abasebenzi bamazinyo,25, 45 nesiguli45 kumele ibekhona. Bonke abakhona egumbini kumele bavikelwe ngoba ubuningi bezinhlayiya ezikhiqizwe ngesikhathi senqubo zizokweqa ukuqoqwa ngamadivayisi okudonsa.36, 45 Kukhonjisiwe ukuthi lezi zinhlayiya zingasakazeka zisuke emlonyeni wesiguli ziye ezandleni, ezingalweni, ebusweni, esifubeni nakwezinye izingxenye zomzimba womsebenzi wamazinyo nokwakheka kwesiguli.45
- Amagilavu angama-nitrile angenayo i-latex kufanele asetshenziswe ngudokotela wamazinyo nabo bonke abasebenzi bamazinyo abasekamelweni.45, 46, 77, 82-83
- Izihlangu zobuso nezembozo zezinwele / zekhanda kufanele zisetshenziswe ngudokotela wamazinyo nabo bonke abasebenzi bamazinyo abasemagumbini.45, 77, 80
- Kungaba imaski eboshelwe kahle, ebangeni lokuphefumula elinganiselwe ukubamba i-mercury noma ingcindezi enhle, imaski evalwe kahle enikeza umoya noma umoya-mpilo kumele igqokwe ngudokotela wamazinyo nabo bonke abasebenzi bamazinyo egumbini.36, 45, 76, 77
- Ukuze uvikele isikhumba nezingubo zesiguli, kudingeka kusetshenziswe umzimba ogcwele, umgoqo ongangeneki, kanye nesithiyo esigcwele ikhanda / ubuso / intamo ngaphansi / eduze kwedamu.45, 77, 80
- Umoya wangaphandle noma umoya-mpilo olethwa ngesifonyo samakhala wesiguli nawo udinga ukuthi usetshenziselwe ukuqinisekisa ukuthi isiguli asidonsi noma yimuphi umusi we-mercury noma i-amalgam particulate ngesikhathi senqubo.45, 77, 80 I-cannula yamakhala iyindlela eyamukelekayo yale njongo inqobo nje uma ikhala lesiguli limbozwe ngokuphelele ngomgoqo ongangeneki.
- Idamu lamazinyo74-76, 84-87 lokho kwenziwa ngezinto ze-nitrile ezingezona i-latex45, 77, 83 kumele ibekwe futhi ivalwe kahle emlonyeni wesiguli.
- I-ejector saliva kumele ibekwe ngaphansi kwedamu lamazinyo ukunciphisa ukutholakala kwe-mercury esigulini.45, 77
- Ngesikhathi sokususwa kokugcwaliswa kwe-amalgam, udokotela wamazinyo kufanele asebenzise i-vacuum yomlomo yomthombo oseduze nendawo yokusebenza (okungukuthi, amasentimitha amabili kuya kwamane ukusuka emlonyeni wesiguli) ukunciphisa ukuvezwa kwe-mercury.45, 88
- Ukukhishwa ngesivinini esikhulu kuveza ukuthwebula okungcono uma kufakwe idivayisi yokuhlanza,45, 87 okungaphoqelekile kepha okuthandwayo.
- Amanzi amaningi ukunciphisa ukushisa45, 74, 76, 77, 86, 89-91 kanye nedivayisi ejwayelekile yokukhipha ngesivinini esikhulu ukuze ibambe ukukhishwa kwe-mercury25, 29, 45, 74-77, 86, 90, 91 kuyadingeka ukunciphisa amazinga e-mercury aseduze.46
- I-amalgam idinga ukuhlukaniswa ibe yizinqe futhi isuswe ibe izingcezu ezinkulu ngangokunokwenzeka,45, 74, 77, 80 usebenzisa ubukhulu obuncane be-carbide drill.29, 86
- Lapho inqubo yokususa isiqediwe, umlomo wesiguli kufanele ufuthwe kahle ngamanzi77, 80 bese uhlanzwa nge-slurry yamalahle, i-chlorella noma i-adsorbent efanayo.81
- Odokotela bamazinyo kumele bahambisane nemithethonqubo kahulumeni, yezwe neyasendaweni ekhuluma ngokuphathwa kahle, ukuhlanzwa kanye / noma ukulahlwa kwezinto ezingcoliswe i-mercury, okokugqoka, okokusebenza, indawo yegumbi kanye naphansi ehhovisi lamazinyo.
- Ngesikhathi sokuvulwa nokunakekelwa kwezicupho zokudonsa ezindaweni zokuqhudelana noma kuyunithi enkulu yokudonsa, abasebenzi bamazinyo kufanele basebenzise imishini efanele yokuvikela echazwe ngenhla.
Kubalulekile ukuqaphela ukuthi njengesivikelo sokuphepha, i-IAOMT ayikukhuthazi ukususwa kokugcwaliswa kwe-amalgam kwabesifazane abakhulelwe noma abancelisa ibele nokuthi i-IAOMT ayincomi ukuthi abasebenzi bamazinyo abakhulelwe noma abancelisayo benze umsebenzi ophazamisa i-amalgam ukugcwaliswa (kufaka phakathi ukususwa kwabo).