Graetz Christian, Plaumann Anna, Rauschenbach Sebastian, Bielfeldt Jule, Dörfer Christof E, Schwendicke Falk
Clinic for Conservative Dentistry and Periodontology, School of Dental Medicine, Christian-Albrechts-University of Kiel, Kiel, Germany.
Department of Operative and Preventive Dentistry, Charité-University of Berlin, Berlin, Germany.
Clin Oral Investig. 2016 Jul;20(6):1193-201. doi: 10.1007/s00784-015-1605-2. Epub 2015 Sep 29.
Periodontal scaling might cause musculoskeletal disorders, and scaling instruments might not only have different effectiveness and efficiency but also differ in their ergonomic properties. The present study assessed ergonomic working patterns of experienced (EO) and less experienced operators (LO) when using hand and powered devices for periodontal scaling and root planning.
In an experimental study using periodontally affected manikins, sonic (AIR), ultrasonic (TIG) and hand instruments (GRA) were used by 11 operators (7 EO/4 LO) during simulated supportive periodontal therapy. Using an electronic motion monitoring system, we objectively assessed the working frequency and positioning of hand, neck and head. Operators' subjective evaluation of the instruments was recorded using a questionnaire.
Hand instruments were used with the lowest frequency (2.57 ± 1.08 s(-1)) but greatest wrist deviation (59.57 ± 53.94°). EO used instruments more specifically than LO, and generally worked more ergonomically, with less inclination of head and neck in both the frontal and sagittal planes, especially when using hand instruments. All groups found hand instruments more tiring and difficult to use than powered instruments.
Regardless of operators' experience, powered instruments were used more ergonomically and were subjectively preferred compared to hand instruments.
The use of hand instruments has potential ergonomic disadvantages. However, with increasing experience, operators are able to recognise and mitigate possible risks.
牙周洁治可能会导致肌肉骨骼疾病，并且洁治器械不仅在有效性和效率上有所不同，其人体工程学特性也存在差异。本研究评估了经验丰富的操作者（EO）和经验较少的操作者（LO）在使用手动和动力器械进行牙周洁治及根面平整时的人体工程学工作模式。
在一项使用患有牙周疾病的人体模型的实验研究中，11名操作者（7名经验丰富者/4名经验较少者）在模拟的支持性牙周治疗过程中使用了声波器械（AIR）、超声波器械（TIG）和手动器械（GRA）。我们使用电子运动监测系统客观地评估了手、颈部和头部的工作频率及位置。使用问卷记录操作者对器械的主观评价。
手动器械的使用频率最低（2.57±1.08次/秒），但手腕偏斜度最大（59.57±53.94°）。经验丰富者比经验较少者更有针对性地使用器械，并且总体上工作方式更符合人体工程学，在额面和矢状面中头部和颈部的倾斜度更小，尤其是在使用手动器械时。所有组都发现手动器械比动力器械更累且更难使用。
无论操作者的经验如何，与手动器械相比，动力器械的使用更符合人体工程学，且在主观上更受青睐。
使用手动器械存在潜在的人体工程学劣势。然而，随着经验的增加，操作者能够识别并减轻可能的风险。
