Removal of simulated biofilm: a preclinical ergonomic comparison of instruments and operators.

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSION

Regardless of operators' experience, powered instruments were used more ergonomically and were subjectively preferred compared to hand instruments.

CLINICAL RELEVANCE: The use of hand instruments has potential ergonomic disadvantages. However, with increasing experience, operators are able to recognise and mitigate possible risks.