Plessas A, Bernardes Delgado M
Peninsula Dental School, Plymouth University (PUPSMD), Plymouth, UK.
Int J Dent Hyg. 2018 Nov;16(4):430-440. doi: 10.1111/idh.12327. Epub 2018 Jan 10.
Musculoskeletal disorders affect a high percentage of dentists, dental hygienists and therapists. Static and awkward working postures are considered as major risk factors. Proper seat selection and use of magnification loupes are promoted for their ergonomic benefits. The aim of this review was to evaluate the existing empirical evidence on the effect of the above interventions on (i) correction of poor posture and (ii) reduction in musculoskeletal pain.
The review was conducted according to the PRISMA guidelines. The review protocol was registered with PROSPERO (CRD42017058580). The Medline via Ovid, CINHAL via EBSCO, Web of Science, OpenGrey and EThOS electronic databases were searched. Prospective experimental studies were considered for inclusion. The Effective Public Health Practice Project Quality Assessment Tool (EPHPP) was used to assess the methodological quality of the included studies.
Eight studies were included in the review. Four investigated the effect of loupes on posture and musculoskeletal pain, 4 the effect of the saddle seats on posture and one of the latter explored the combined effect of magnification and use of saddle seats on posture.
Based on a limited number of studies, the use of ergonomic saddle seats and dental loupes leads to improved working postures. The use of loupes appears to relieve shoulder, arm and hand pain. However, their effect on neck pain is scarce. None of the studies reported on the effect of the saddle seats on musculoskeletal pain. Future well-powered prospective longitudinal studies are deemed necessary to confirm the conclusions of this review.
肌肉骨骼疾病在牙医、口腔保健员和治疗师中具有较高的发病率。静态和不良的工作姿势被认为是主要风险因素。由于其对人体工程学的益处，提倡选择合适的座椅并使用放大倍率的放大镜。本综述的目的是评估上述干预措施对（i）纠正不良姿势和（ii）减轻肌肉骨骼疼痛的现有实证证据。
本综述按照PRISMA指南进行。综述方案已在PROSPERO（CRD42017058580）注册。通过Ovid检索Medline、通过EBSCO检索CINHAL、Web of Science、OpenGrey和EThOS电子数据库。纳入前瞻性实验研究。使用有效公共卫生实践项目质量评估工具（EPHPP）评估纳入研究的方法学质量。
八项研究纳入本综述。四项研究调查了放大镜对姿势和肌肉骨骼疼痛的影响，四项研究调查了鞍形座椅对姿势的影响，其中一项研究探讨了放大倍率和使用鞍形座椅对姿势的综合影响。
基于有限数量的研究，使用符合人体工程学的鞍形座椅和牙科放大镜可改善工作姿势。使用放大镜似乎可缓解肩部、手臂和手部疼痛。然而，其对颈部疼痛的影响尚少。没有研究报告鞍形座椅对肌肉骨骼疼痛的影响。未来需要进行有充分样本量的前瞻性纵向研究以证实本综述的结论。
