Specialist article

High treatment comfort for yourorthodontic practiceGood ergonomics: Treatment unit EMCIA ORTHO

Creating a feel-good working environment is essential for safe and stressfree orthodontic procedures. And it is becoming even more importantbecause orthodontic patients come from all age groups today: adults andadolescents as well as, more and more frequently, elderly persons. In
connection with the latter group, shorter spans of attention and limited
mobility play a part. There are myriad individual orthodontic solutions, all ofwhich strive to ensure that the therapy is efficient as well as comfortable –this is important for dentists, assistants and patients. One decisive factor is
the treatment unit: not only should it fit to the interior design of the dental
practice, it should also offer optimal functionality – ideally, it should becompact, user-oriented and pleasant for the patient.

Many special models of treatment units have been designed for the specificrequirements of an orthodontic practice. The overall goal is to support clinicians intheir effort to carry out orthodontic procedures successfully. One objective in thisrespect is achieving an efficient and at the same time comfortable and low-stressworking style. Since the treatment unit is a dominating feature of the room, it is of
special interest – and not only for the patients. Naturally, it can cater to design
fans, but it must definitely fulfill the demands of clinical functionality to a highdegree as well. Ideally, it should do this for a whole (working) life. One aspect isoften underestimated, at least until it can no longer be ignored because of pain: wemean the neck and back pain that many practitioners suffer from in the course of
their professional career. Around 90% of all dentists have experienced workrelated neck and/or back pain at some point. Nearly 70% state that the symptoms
occur within one week, 50% say it actually occurs after just four hours of working.
In contrast, posture that doesn’t cause pain has a positive effect on physicalwellbeing and indirectly also affects the quality of the treatment: it goes without
saying that if you feel good, you can work at an optimal level in your practice everyday.
Ergonomic work posture – short period of learning, long-term benefits
The neck and back pain mentioned above usually can be traced back to incorrect
posture. It seems plausible that dentists are exposed to this problem more thanany other group of physicians: they usually sit to the side of the patient and in orderto gain an ideal view of the inside of the mouth, they have to twist their upper body.
Whereas most patients leave the treatment chair after a relatively short period oftime, “the dentist has to bear up the entire working day, his whole working life,”
explains Professor Dr. Jerome Rotgans, President der European Society of Dental
Ergonomics (ESDE). Rotgans recommends that one should pay as much attention
as possible to one’s posture not only in but also outside the practice as much as
possible so as to avoid reverting to unhealthy posture. In addition, he advises thatdentists should take breaks, change between sitting and standing and walk asmuch as possible (e.g. meet patients in the waiting room).

By now most dentists have heard of an ergonomic-functional treatment concept
developed by the American dentist Dr. Daryl R. Beach in the 1950s, which has
been practiced successfully since then. It ensures an essentially pain-free working
style by encouraging the practitioner to avoid physical strain and work withbalanced posture. Dr. Beach propounds a working posture that supports our
natural physiological posture and movements. Thus, the concept primarily is basedon natural and stable posture, with only the lower arms working actively. In otherwords, the practitioner should sit upright, relaxed and balanced, and reduce
physical strain to a minimum. In this way, the typical back pains experienced bydentists can be prevented effectively.

Consistent implementation with the help of special treatment units
About 50 years ago, the proven ergonomic concept developed by Dr. Beach also
substantially influenced the development of new generations of treatment units:
accordingly, the Japanese manufacturer Morita developed a dental chair that helps
the practitioner take on a healthy physiological working posture. In 1964, this chairrevolutionized dental work: Morita’s Spaceline was the first dental chair in the world
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that allowed dentists to sit while treating patients in a supine position. The unit wasa real counter-design to the models customary 50 years ago. The customary
European treatment units prior to 1963 were large and plump, whereas Spaceline
introduced design and innovation to dental practices. As recommended by Dr.
Beach, the dentist now sat behind the patient in a so-called 12-o’clock position,
which promotes precision because the instruments located in the back rest as wellas the dentist’s and assistant’s elements are within easy reach at any time –without needing to twist the spine or readjust your position. In addition, alloperating elements, e.g. for the handpieces and controlling the treatment unit, weremounted in a foot pedal. And the form of the half-round headrest was optimized tohold the patient’s head in a comfortable centered position. Furthermore, theworkplace promotes natural posture and takes into consideration the intuitive
motions of the practitioner as well as the distances covered by the practice team.
Accordingly, the focal point of the Spaceline concept was everyone involved in thedental treatment and this still is evident in the current versions of Spaceline EMCIA(Figure 1).
Creating freedom – for young and oldOrthodontists can benefit from the treatment units of the Spaceline EMCIA productline, too: a special orthodontic model is available for the special requirements of anorthodontic practice. The unit is designed to support precise treatments and natural
posture as well as save space.

EMCIA ORTHO’S special features, i.e. fully

swivelling additional tray, instruments integrated in the backrest and the foldaway
foot section, optimize workflow and ensure more freedom of movement for thepractice team. Amongst other things, children, whose locomotor system is not fully
developed yet, and older patients with limited mobility, benefit from the integrated
instruments: they can leave the dental chair more easily since there are no hanging
instrument tubes. In view of the compact design several treatment units can beinstalled in one room or single units can be set up in small spaces so as to provide
privacy to patients. This aspect is gaining importance because more and more
older patients are deciding to undergo orthodontic treatment. Accordingly, thespace-saving design gives you freedom to design the treatment room as needed,
for example, installing several treatment units in one room or setting up small
practice rooms (Figure 2). Another benefit for small patients or patients with limited
mobility is the automatic foldaway foot section, which allows patients to get on andoff the chair without any obstruction. Moreover, the option of sitting upright ensures
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efficient functional diagnostics (e.g. craniomandibular dysfunction). In this position,
the jaw is in its natural position for an impression. Additional comfort for patients isensured by the slow-speed mode (particularly when working with the microscope)and special upholstery that adapts to the shape of the body so as to minimize
tension or fatigue during long treatment sessions.

Optimum workflow support
The treatment concept of Spaceline EMCIA is enhanced by ergonomicallydesigned instruments (e.g. scaler, extraction forceps, oral mirror, all made byMorita) (Figure 3). Moreover, Morita also offers efficient and gentle solutions fordiagnostics, the starting point of every orthodontic procedure: the combination
system Veraviewepocs 3D R100, for example, features a unique triangular field ofview, which is based on the natural form of the dental arch, and scans only theareas that are relevant for clinical purposes (the „R“ in „R100“ stands for ReuleauxTriangle). Two new fields of view (diameter: Ø R100 × 40 mm and Ø 80 × 40 mm)
were added to the device for IDS. Since the height can be adjusted to individual
needs, it is easier to make scans of the maxilla and mandible. The result: evenmore accurate positioning and reduced dosage – this is of particular importance forchildren and adolescents.

Prepared for a long and comfortable working life
When deciding about state-of-the-art equipment for dental practices, orthodontists
have to take into consideration current social trends, such as population ageing,
and ask themselves: Which treatment units can master a higher number of adultpatients, for example? Here again, the more than 50 years of consistency of theSpaceline product line comes to fruition. Despite all further developments, theseries has always remained true to its principle of focusing on the personsinvolved. It goes without saying that the wish for a highly efficient and, at the sametime, comfortable treatment is timeless. Nonetheless, a (dentist’s) working life will
come to a well-deserved end – hopefully without any symptoms. To this end, it may
prove helpful to know that Morita offers workshops to teach ergonomic working
posture (Note: 14 continuing education points). Experts will explain how to treat
your patients from the 12-o’clock position while observing natural and physiologicalposture. In addition to achieving a strain-free and physiological working style in linewith Dr. Daryl Beach, anyone wishing to further optimize their treatment outcomes
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can speak with knowledgeable experts about the treatment unit EMCIA ORTHO –for a long, untroubled working life.

FiguresFig. 1: Easy access to all instruments (Spaceline EMCIA, Morita)

Fig. 2: Maximum comfort and minimum space requirements (Spaceline EMCIA,Morita)

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Fig. 3: Ergonomic instrument design for balanced working posture (oral mirrorMXS, Morita)

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