АNALYSIS OF CLINICAL AND EXPERIMENTAL FORECASTING OF INFLUENCE OF ERGONOMICS OF DENTISTS WORK ON THE RESULT OF ENDONTIC TREATMENT
Authors: Ratushniy R.I. , Goderdzi N. , Goncharuk-Khomyn M.Yu. , Kostenko S.B. , Penzelyk I.V. , Chobeі A.S. 
Published: April 2022

Abstract. The ergonomic aspect of work is one of the keys to the daily practice of a dentist. In-depth study and development of ways to optimize the basic ergonomic principles of work, monitoring the dynamics of implementation and, if necessary, the possibility of their correction is an important scientific and practical issue that can increase the level of dental care.

The aim of the study was to assess the relationship between the ergonomic components of the work of dentists and the outcome of endodontic treatment and the risk of errors in the treatment of root canals with software.

Materials and methods: target research methods Rapid Upper Limb Assessment (for the upper extremities) and Rapid Entire Body Assessment (for the whole body of the dentist), StatPlus Pro software, X-ray examination. Simulation of changes in the position of individual components of the musculoskeletal system during the treatment of root canals and the accompanying analysis of the obtained numerical parameters of these changes were performed using adapted software Tecnomatix Jack (Siemens).

Results and discussion. Each stage of the dentist's work cycle during endodontic interventions was stratified in the form of segmented scenarios, which were compared with video monitoring data to ensure a sufficient level of approximation; then separated the facts of deviations from the ergonomically-reasoned position of the body of the dentist, taking into account the recurrence of their occurrence and providing an interpretation of the results in terms of quantitative and qualitative characteristics of the observed deviations.

Based on the data of systematization of the main deviations of individual elements of the musculoskeletal system and the body of the dentist as a whole from the ergonomic-reasoned ranges, first corrected the most critical violations in the digital environment and re-test according to RULA and REBA organization of the work process. Systematization of data of the regression analysis, it is possible to note characteristic feature of decrease in the frequency of registration of the cases of the mistakes made during endodontic treatment of all groups of teeth, at the achievement of the highest values of RULA and REBA indicators.

According to the results of modeling and theoretical justification of the implementation of the necessary ergonomic changes for each of the dentists of the study, the sample formulated a set of individual recommendations, the implementation of which in the workflow helped increase the effectiveness of endodontic interventions and reduce the number of errors.

Conclusions. Modeling the main patterns of changes in the working position of dentists during root canal treatment and analysis of such in the structure of the digital environment according to the data, promotes targeted identification of problematic elements of the workflow in terms of compliance with ergonomic criteria and specifics of their changes, the possible fact of using optically magnifying equipment, work with rotary and manual types of endodontic instruments.

The proposed approach to the optimization of endodontic treatment in terms of compliance with relevant ergonomic criteria is individual-specific, and the systematization of general characteristics, which were registered among the entire sample, will help expand the integrated system of improving the quality and efficiency of dental care in its structure.

Prospects for further research. Evaluation of the practical significance and actual feasibility of using the approach of discrete-event modeling of triangulation relations to optimize the ergonomic components of the work process during endodontic treatment.