The daily dentist practicing productivity improvement is still actual problem all over the world. Today it is mainly solved by modification of equipment, instruments, devises etc. The most important factors that allow reduce unjustified waste of working time are modern methods of treatment and technologies implementation. This is the area of “ergonomics” – a science that deals with designing and arranging workplace.

Although the basic principles of ergonomics were used by humans since the beginning of time, it took long time to form it as a science. The term “ergonomics” was firstly proposed by polish naturalist Wojciech Jastrzębowski in 1857. The further development of ergonomics was stimulated by appearance in the 20th century of new technologies as well as machines the people had to operate. In dentistry it was mainly associated with the scientists and practitioners from Germany, the USA, Japan, Great Britain and the USSR. Despite the progress that was reached during those years the range of work-related disorders and diseases among dental practitioners remain very high.

Main tasks of dental ergonomic are:
1. To reduce dentist and dental assistant workplace labour -intensity, eliminate or significantly decrease the risks of the work-related diseases appearance.
2. To improve treatment methods and bring down patient’s stresses
3. Extra time release due to more effective everyday workplace conditions
4. Usage of released free time for planning the professional-growth activities, that will improve quality of treatment afterwards

Presently the four-handed dentistry comply the ergonomics standards. Proprioceptive derived “p.d.” concept, which was proposed by Dr. Daryl R. Beach in far 1960s is one of the most optimal. It provides to dentist and dental assistant optimal working position, maximally eliminates muscle stresses from professional manipulation, increases control and effectiveness of treatment. Kadowaki and Kaneko in the research (1999) reported that percentage of dentist’s body “stress-free time” during working day increased from 39,7 to 98,7 % comparatively to traditional workplace.

“P.d.” concept is based on the body orientation in space analysis provided by proprioreceptors that are located in muscle-joint tissues. These receptors help nervous system to conclude and provide information about human body position, movement and application of force. Knowledge and understanding of the basic rules and manipulation sequences of the “p.d.” concept helps practising dentist on-ones own to implement the optimal ergonomic parameters of workplace.

Nowadays, thanks to tight cooperation between practitioners, engineers and equipment manufacturers, four basic concepts of dental workplace present: 1. Dentist instruments and devises are located right side toward the dental chair (Schon and Schneider, Germany); 2. Dentist instruments and devises are located behind dental chair headrest (Barker, USA); 3. Dentist instruments and devises are located at the side of dental assistant and above toward the dental chair (Kilpatrick, USA); 4. Dentist instruments and devises are located right side chair headrest (Beach, Japan). Each basic concept has 4 additional possibilities for dental assistant instruments and devises location. All 16 possible variants are DIN- and ISO standardized. In spite of different ways in dental workplace organization, all 4 basic concepts respect 5 main principles of four-handed dentistry: 1. Rational working position of a dentist, dental assistant and position of a patient 2. Presence of qualified dental assistant 3. Complete cycle of organization of treatment process 4. Minimization of manipulation movements 5. Infection control

Introduction of ergonomic workstation in daily practice will give opportunity for a dentist and dental assistant to increase effectiveness of treatment, process satisfaction and reduce occupational risks.

Keywords: ergonomics, dental practice, four-handed dentistry, proprioceptive derived

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