放大镜和显微镜对口腔修复医生体位的人体工程学影响

doi:10.19723/j.issn.1671-167X.2020.05.026

北京大学学报（医学版） ›› 2020, Vol. 52 ›› Issue (5): 948-951. doi: 10.19723/j.issn.1671-167X.2020.05.026

放大镜和显微镜对口腔修复医生体位的人体工程学影响

刘晓强¹,廖宇²,杨洋^1,^∆(),周建锋¹,谭建国^1,^∆()

1.北京大学口腔医学院·口腔医院,修复科,北京 100081
2.北京大学口腔医学院·口腔医院,综合二科,国家口腔疾病临床医学研究中心口腔数字化医疗技术和材料国家工程实验室口腔数字医学北京市重点实验室,北京 100081

收稿日期:2018-08-21 出版日期:2020-10-18 发布日期:2020-10-15
通讯作者: 杨洋,谭建国 E-mail:Yyangpkuss@163.com;tanwume@vip.sina.com
基金资助:
中华口腔医学会青年科研基金(CSA-R2018-01);北京大学口腔医院教学改革项目基金(2017-PT-01)

Effects of loupes and microscope on the prosthodontist’s posture from ergonomic aspects

Xiao-qiang LIU¹,Yu LIAO²,Yang YANG^1,^∆(),Jian-feng ZHOU¹,Jian-guo TAN^1,^∆()

1. Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
2. Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China

Received:2018-08-21 Online:2020-10-18 Published:2020-10-15
Contact: Yang YANG,Jian-guo TAN E-mail:Yyangpkuss@163.com;tanwume@vip.sina.com
Supported by:
Chinese Stomatological Association Research Fund(CSA-R2018-01);Program for Educational Reform of Peking University School and Hospital of Stomatology(2017-PT-01)

摘要/Abstract

摘要：

目的:研究放大镜和显微镜对口腔修复医生贴面牙体预备时体位的影响,从人体工程学角度对放大镜和显微镜的临床应用价值进行评价。方法:从北京大学口腔医院修复科选择20名口腔修复医生进行前瞻性、单盲、自身对照试验。研究过程中不告知受试者研究的试验假设和真实目的,每人依次在常规视野下(空白对照组)、2.5倍头戴式放大镜下(放大镜组)和8倍医用显微镜下(显微镜组)在仿头模内完成右上中切牙开窗型贴面牙体预备,试验过程中拍摄医生的侧面和正面体位照片。贴面牙体预备完成后,由医生本人利用视觉模拟评分法对自身体位进行主观评分,由两名专家利用侧面和正面体位照片按照“改良口腔医生体位评分表”对医生的体位进行专家评分。结果:空白对照组、放大镜组和显微镜组的主观评分分别为4.55±1.96、7.90±1.12、9.00±0.92,三组之间差异有统计学意义(P<0.05);专家评分分别为16.38±1.52、15.15±1.30、13.60±0.88,三组之间差异有统计学意义(P<0.05)。三组的专家评分在躯干前后向位置(1.33±0.41、1.03±0.11、1.00±0.00)、头颈前后向位置(2.75±0.38、2.13±0.36、1.23±0.38)、肘关节位置(1.38±0.43、1.40±0.45、1.13±0.22)和肩部高度(1.43±0.41、1.23±0.34、1.13±0.28)这4项评分上的差异有统计学意义(P<0.05),其中,在头颈前后向位置和肘关节位置方面,放大镜组与显微镜组之间的差异有统计学意义(P<0.05)。结论:放大镜和显微镜均能改善口腔修复医生牙体预备时的体位,其中显微镜的效果更好,从人体工程学的角度二者均具有较高的临床应用价值。

关键词: 放大镜, 显微镜, 口腔医生, 体位, 人体工程

Abstract:

Objective: To assess the effects of loupes and microscope on the posture of prosthodontists when preparing the laminate veneer, and to assess the clinical value of loupes and microscope from the ergonomic aspects. Methods: Twenty young prosthodontists from Department of Prosthodontics, Peking University School and Hospital of Stomatology were recruited into this study, which was a prospective, single blind, self-control trials. The research hypothesis was concealed and the participants were deceived about the precise purpose of the study to counterbalance the lack of direct blinding. The prosthodontists prepared laminate veneers of open window type in the artificial dental model, under routine visual field (control group), 2.5× headwear loupes (loupes group), and 8× operating microscope (microscopic group) by turning. The participants were photographed from profile view and front view. Thereafter, the subjective assessment was performed by themselves using the visual analogue score (VAS). The expert assessment was performed by two professors using modified-dental operator posture assessment instrument on the basis of photographs of the profile view and front view. Results: The subjective assessment scores for the control group, loupes group and microscopic group were 4.55±1.96, 7.90±1.12, and 9.00±0.92, respectively. There was significant difference between the three groups’ subjective scores (P<0.05). The expert assessment scores for the control group, loupes group and microscopic group were 16.38±1.52, 15.15±1.30, and 13.60±0.88, respectively. There was significant difference between the three groups’ expert assessment scores (P<0.05). Specifically, the three groups’ expert assessment scores were significantly different (P<0.05) in trunk position (front to back) (1.33±0.41, 1.03±0.11, 1.00±0.00), head and neck position (front to back) (2.75±0.38, 2.13±0.36, 1.23±0.38), elbows level (1.38±0.43, 1.40±0.45, 1.13±0.22), and shoulders level (1.43±0.41, 1.23±0.34, 1.13±0.28). Thereinto, the microscopic group was better than loupes group in head and neck position (front to back) and elbows level (P<0.05). Conclusion: Loupes and microscope improve the posture of the prosthodontist when preparing the laminate veneer, in which the microscope is better than loupes. Therefore, the magnification devices have clinical value from the ergonomic aspects.

Key words: Loupes, Microscopes, Dentists, Posture, Human engineering

中图分类号:

刘晓强,廖宇,杨洋,周建锋,谭建国. 放大镜和显微镜对口腔修复医生体位的人体工程学影响[J]. 北京大学学报（医学版）, 2020, 52(5): 948-951.

Xiao-qiang LIU,Yu LIAO,Yang YANG,Jian-feng ZHOU,Jian-guo TAN. Effects of loupes and microscope on the prosthodontist’s posture from ergonomic aspects[J]. Journal of Peking University (Health Sciences), 2020, 52(5): 948-951.

图/表 2

图1

表1

体位的主观评分与专家评分结果"

Group	Subjective evaluation (VAS scores^*, $x -$ ±s)	Expert assessment evaluation ( $x -$ ±s)
Group	Subjective evaluation (VAS scores^*, $x -$ ±s)	Total scores^*	Hips	Trunk (front to back)^*	Trunk (side to side)	Trunk (rotation)	Head and neck (front to back)^*
Control group	4.55±1.96^a	16.38±1.52^a	1.58±0.44^a	1.33±0.41^a	1.05±0.15^a	1.13±0.22^a	2.75±0.38^a
Loupes group	7.90±1.12^b	15.15±1.30^b	1.58±0.44^a	1.03±0.11^b	1.05±0.15^a	1.08±0.18^a	2.13±0.36^b
Microscopic group	9.00±0.92^c	13.60±0.88^c	1.55±0.46^a	1.00±0.00^b	1.00±0.00^a	1.00±0.00^a	1.23±0.38^c
P value	<0.001	<0.001	0.727	<0.001	0.270	0.091	<0.001
Group	Expert assessment evaluation ( $x -$ ±s)
Group	Head and neck (side to side)	Head and neck (rotation)	Upper arms	Elbows^*	Shoulder (relaxed or slumped)	Shoulder level^*	Wrists (flexion or extension)
Control group	1.03±0.11^a	1.00±0.00	1.70±0.55^a	1.38±0.43^a	1.03±0.11^a	1.43±0.41^a	1.00±0.00
Loupes group	1.05±0.15^a	1.00±0.00	1.63±0.51^a	1.40±0.45^a	1.00±0.00^a	1.23±0.34^a,b	1.00±0.00
Microscopic group	1.00±0.00^a	1.00±0.00	1.58±0.49^a	1.13±0.22^b	1.00±0.00^a	1.13±0.28^b	1.00±0.00
P value	0.377		0.180	0.001	0.377	0.004

表1

参考文献 15

[1]	Al-Mohrej OA, AlShaalan NS, Al-Bani WM, et al. Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study[J]. BMJ Open, 2016,6(6):e011100. doi: 10.1136/bmjopen-2016-011100 pmid: 27324712
[2]	Partido BB, Wright BM. Self-assessment of ergonomics amongst dental students utilising photography: RCT[J]. Eur J Dent Educ, 2018,22(4):223-233. doi: 10.1111/eje.12335 pmid: 29498176
[3]	Hayes M, Cockrell D, Smith DR. A systematic review of musculoskeletal disorders among dental professionals[J]. Int J Dent Hyg, 2009,7(3):159-165. doi: 10.1111/j.1601-5037.2009.00395.x pmid: 19659711
[4]	陈曦, 边专, 聂敏. 人体工程学原则在口腔医学中的应用[J]. 国外医学·口腔医学分册, 2006,33(2):134-135, 138.
[5]	Maillet JP, Millar AM, Burke JM, et al. Effect of magnification loupes on dental hygiene student posture[J]. J Dent Educ, 2008,72(1):33-44. pmid: 18172233
[6]	Hayes MJ, Osmotherly PG, Taylor JA, et al. The effect of wearing loupes on upper extremity musculoskeletal disorders among dental hygienists[J]. Int J Dent Hyg, 2014,12(3):174-179. doi: 10.1111/idh.12048
[7]	Marklin RW, Cherney K. Working postures of dentists and dental hygienists[J]. J Calif Dent Assoc, 2005,33(2):133-136. pmid: 15816703
[8]	Fals Martínez J, González Martínez F, Orozco Páez J, et al. Musculoskeletal alterations associated factors physical and environmental in dental students[J]. Rev Bras Epidemiol, 2012,15(4):884-895. doi: 10.1590/s1415-790x2012000400018 pmid: 23515782
[9]	Memarpour M, Badakhsh S, Khosroshahi SS, et al. Work-related musculoskeletal disorders among Iranian dentists[J]. Work, 2013,45(4):465-474. doi: 10.3233/WOR-2012-1468
[10]	Garcia P, Gottardello ACA, Wajngarten D, et al. Ergonomics in dentistry: experiences of the practice by dental students[J]. Eur J Dent Educ, 2017,21(3):175-179. doi: 10.1111/eje.12197 pmid: 26998591
[11]	Eichenberger M, Biner N, Amato M, et al. Effect of magnification on the precision of tooth preparation in dentistry[J]. Oper Dent, 2018,43(5):501-507. doi: 10.2341/17-169-C pmid: 29513642
[12]	Branson BG, Bray KK, Gadbury-Amyot C, et al. Effect of magnification lenses on student operator posture[J]. J Dent Educ, 2004,68(3):384-389. pmid: 15038640
[13]	Hayes MJ, Taylor JA, Smith DR. Predictors of work-related musculoskeletal disorders among dental hygienists[J]. Int J Dent Hyg, 2012,10(4):265-269. doi: 10.1111/j.1601-5037.2011.00536.x
[14]	Ariens GA, Bongers PM, Douwes M, et al. Are neck flexion, neck rotation, and sitting at work risk factors for neck pain? Results of a prospective cohort study[J]. Occup Environ Med, 2001,58(3):200-207. doi: 10.1136/oem.58.3.200 pmid: 11171934
[15]	Wilson AT. Counterfactual consent and the use of deception in research[J]. Bioethics, 2015,29(7):470-477. doi: 10.1111/bioe.12142 pmid: 25425459

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放大镜和显微镜对口腔修复医生体位的人体工程学影响

Effects of loupes and microscope on the prosthodontist’s posture from ergonomic aspects

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