ERGONOMIC ANALYSIS OF DENTAL TREATMENTS TASKS: DISCOMFORT FACTOR IDENTIFICATION AND IMPACT ON BODY REGIONS

Year 2018, , 47 - 67, 31.05.2018

Müge Hanefioğlu Orhan Korhan

https://doi.org/10.31796/ogummf.330846

Abstract

Amaç: Diş hekimliği
mesleği, uzun süreli statik kas yüklemesi, yüksek oranda tekrarlanan ve monoton
çalışma, dokuların kuvvetle zorlanması veya mekanik olarak sıkıştırılması ve
titreşimli araçların kullanılmasını içerir. Bu nedenle diş hekimlerinin, maruz
kaldıkları mesleki kas-iskelet rahatsızlıkları (MKİSR) yüzünden maliyetli
sağlık sorunları yaşayarak erken emekli olmaları söz konusudur. Bu çalışmanın
amacı dişhekimlerinin yaşamakta olduğu kas iskelet sistemi rahatsızlıklarının
risk faktörlerini tanımlamak ve bölgesel olarak tespit edip, etki derecelerini
incelemektir.

Gereçler: Bu
çalışma kapsamında bir anket hazırlanmış olup, çeşitli üniversitelerin,
hastahanelerin ve diş kliniklerinde görev yapan 67 dişhekimi tarafından
doldurulmuştur. Diş hekimlerinin altı vücut bölgesine en yaygın tedavi
yöntemleri esnasında EMG ölçümleri yapılmıştır. İstatistiksel olarak anlamlı ve
MKİSR’nın oluşmasına sebep olan faktörleri belirlemek amacıyla Diskriminant
Analiz yöntemi kullanılmıştır. EMG deneyinden elde edilen sonuçları ise ANOVA
kullanılarak belirlenen MKİSR faktörleri teyit edilmiştir.

Bulgular: Diş hekimlerinin
tedavi esnasında en sık rastlanan pozisyon statik ve uzun süreli oturma / durma
pozisyonda oldukları tespit edilmiştir. Son 12 ayda yaşanan kas iskelet sistemi
rahatsızlıklarının en çok görülmekte olduğu bölgeler boyun, el/bilek, üst sırt,
ve omuzlar olarak saptanmıştır. Son 7 günde ise en çok dirsek, ayaklar, kalça,
ve bilek/el bölgelerinde rahatsızlık yaşandığı tespit edilmiştir.

Sonuçlar: Diş
hekimlerinin uygulamakta olduğu endodonti, dolgu, diş çekimi, muayene, ve
çıkarılabilir protez tedavilerinin, vücut bölgeleriyle etkileşerek kas-iskelet
sistemi rahatsızlıklarına yol açtığı ortaya çıkmıştır. Ancak, vücut bölgesi diş
çekimi, endodonti ve diş muayenesi esneasında oluşabilecek tek anlamlı risk
faktörü olarak bulunmuştur.

Keywords

Kas-iskelet rahatsızlıkları, Diş hekimi, Diş tedavisi, emg

Ergonomic Analysis of Dental Treatments Tasks: Discomfort Factor Identification and Impact on Body Regions

Abstract

Objectives: Dentistry
profession involves in prolonged static muscle loads, highly repetitive and
monotonous work, high force exertion or mechanical compression of tissues, and
using vibrated tools. Therefore dentists are exposed to work-related
musculoskeletal disorders (WRMSDs), which results in costly health problems and
early retirements. This research aims to determine the risk factors of
musculoskeletal discomforts among dentists, and to identify the impact of the
dental tasks on the body regions during particular treatments.

Materials
and Methods: A
questionnaire is created and fulfilled by 67 dentists from universities,
hospitals, and dental offices. Electromyography studies were applied on six
body regions of randomly selected three dentists during most common dental
treatments. Discriminant Analysis was applied to determine whether a set of
variables is effective in predicting category membership, and to identify
statistically significant factor(s) which contribute(s) formation of the
WRMSDs. ANOVA was utilized to analyze the results which were obtained from sEMG
experiment and to determine the risk factors of work related musculoskeletal
disorders. 

Results: The most common position
of the dentists while performing their profession was static and prolonged
sitting / standing position. Musculoskeletal discomforts were experienced
during the past 12 months in neck, hand / wrist, upper back, and shoulder
regions; and during the past 7 days in elbows, feet, hip, and wrist / hand
regions.

Conclusions: There is no significant
factor on dental filling therapy, tooth cleaning, fixed prosthodontics, and
removable prosthodontics treatments. However, body region is the only
significant factor on tooth extraction, endodontic and dental examination
treatments.

Keywords

Musculoskeletal discomfort, Dentists, dental task, emg

References

• [Åkesson, I., Johnsson, B., Rylander, L., Moritz, U. Musculoskeletal disorders among female dental personnel - clinical examination and a 5-year follow-up study of symptoms. Int Arch Occup Environ Health. 1999; 72: 395-403.
• Åkesson, I., Balogh, I., Hansson, G.A. Physical workload in neck, shoulders and wrists/hands in dental hygienists during a work-day. Applied Ergonomics. 2012; 43: 803-811.
• Alexandre, P.C.B., Silva, I.C.M., Souza, L.M.G., Câmara, V.M., Palácios, M., Meyer, A. Musculoskeletal Disorders among Brazilian Dentists. Archives of Environmental & Occupational Health. 2011; 66(4).
• Cherniack MG1, Dussetschleger J, Bjor B. Musculoskeletal disease and disability in dentists. Work. 2010. 35(4): 411-8.
• Dong, H., Loomer, P., Barr, A., LaRoche, C., Young, E., Rempel, D. The effect of tool handle shape on hand muscle load and pinch force in a simulated dental scaling task. Applied Ergonomics. 2006; 38: 525–531.
• Finsen, L., Christensen, H., Bakke, M. (1998). Musculoskeletal disorders among dentists and variation in dental work. Applied Ergonomics. 1998; 29(2): 11-12S.
• Hayes, M.J., Smith, D.R., Taylor, JA. Musculoskeletal disorders and symptom severity among Australian dental hygienists. BMC Research Notes 2013 6:250.
• Kar, G., Mullick, A.. Designing with Users: A case study for design of dental workspace. Proceedings of the Human Factors and Ergonomics Society 56th Annual Meeting. 2012.
• Khan, S.A., Yee, Chew, K. Effect of working characteristics and taught ergonomics on the prevalence of musculoskeletal disorders amongst dental students. 2013; BMC Musculoskeletal Disorders. 2013, 14:118.
• Kuorinka I, Jonsson B, Kilbom A, et al. . Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms, Applied Ergonomics. 1987, 18: 233-237.
• Külcü, D.G., Gülşen, G., Altunok, T.Ç., Küçükoğlu, D., Naderi, S. Neck and Low Back Pain among Dentistry Staff. Turk J Rheumatol. 2010; 25: 122-9.
• Leggat P.A., Kedjarune, U., Smith, D.R. Occupational health problems in modern dentistry: a review. Industrial Health. 2007; 45(5):611-21.
• Lin, T., Hsieh, T.Y., Horowitz, A.M., Chen, K.K., Lin, S.S., Lai, Y.J., Hsiao, F.Y., Chang, C.S. Prevalence of and risk factors for musculoskeletal complaints among Taiwanese dentists. Journal of Dental Science. 2012; 7: 65-71.
• Madaan, V., Chaudhari, A. Prevalence and Risk Factor associated with Musculoskeletal Pain among Students on MGM Dental College: A Cross- Sectional Survey. Journal of Contemporary Dentistry. 2012; 22-27.
• Morse T, Bruneau H, Dussetschleger J. Musculoskeletal disorders of the neck and shoulder in the dental professions. Work. 2010; 35(4): 419-29.
• Nutalapati, R., Gaddipati, R., Chitta, H., Pinninti, M., Boyapati, R. Ergonomics in Dentistry and the Prevention of Musculoskeletal Disorders in Dentists. The internet journal of occupational health. 2009; 1(1).
• Patel, H.L., Marwadi, M.R., Mihir, R., Piyanka, P. Prevalence and Associated Factors of Back Pain among Dentists in South Gujarat. National Journal of Medical Research. 2012.
• Puriene, A., Aleksejuniene, J., Petrauskiene, J., Balciuniene, I., Janulyte, V. Self-reported occupational health issues among Lithuanian dentists. Industiral Health. 2008; 46(4):369-74.
• Rabiei, M., Shakiba, M., Shahreza, H.D., Talebzadeh, M. Musculoskeletal Disorders in Dentists. International Journal of Occupational Hygiene by Iranian Occupational Health Association (IOHA) IIJOH. 2012; 4: 36-40.
• Rolander B, Karsznia A, Jonker D, Oberg T, Bellner AL Perceived contra observed physical work load in Swedish dentists. Work. 2005; 25(3): 253-62.
• Sanders MJ, Turcotte CM. Occupational stress in dental hygienists. Work. 2010; 35(4): 455-65.
• Thanathornwong, B., Suebnukarn, S., Songpaisan, Y., Ouivirach, K. A system for predicting and preventing work-related musculoskeletal disorders among dentists. Computer Methods in Biomechanics and Biomedical Engineering. 2012; 17( 2): 177–18.
• Yousef, M.K., Al-Zain, A.O. Posture Evaluation of Dental Students. JKAU: Med. Sci. 2009; 16(2).
• Zoidaki, A., Riza, E., Kastania, A., Papadimitriou, E., Linos, A. Musculoskeletal disorders among dentists in the Greater Athens area, Greece: risk factors and correlations. J Public Health. 2013; 21: 163–173.