华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (4): 428-435.doi: 10.7518/hxkq.2022.04.009

• 临床研究 • 上一篇    下一篇

口腔技师使用放大镜及显微镜的人体工程学效果评价研究

余嘉怡(), 楼雨欣, 祝丽青, 任薇, 杨兴强, 于海洋()   

  1. 口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院修复科,成都 610041
  • 收稿日期:2021-09-22 修回日期:2022-04-02 出版日期:2022-07-25 发布日期:2022-07-27
  • 通讯作者: 于海洋 E-mail:649461390@qq.com;yhyang6812@scu.edu.cn
  • 作者简介:余嘉怡,硕士,E-mail:649461390@qq.com
  • 基金资助:
    四川省科技计划重点研发项目(2020YFS0040)

Effects of loupes and microscopes on a dental technician’s working posture from ergonomic aspects

Yu Jiayi(), Lou Yuxin, Zhu Liqing, Ren Wei, Yang Xingqiang, Yu Haiyang.()   

  1. State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2021-09-22 Revised:2022-04-02 Online:2022-07-25 Published:2022-07-27
  • Contact: Yu Haiyang. E-mail:649461390@qq.com;yhyang6812@scu.edu.cn
  • Supported by:
    Sichuan Science and Technology Program(2020YFS0040);Correspondence: Yu Haiyang, E-mail: yhyang6812@scu.edu.cn

摘要:

目的 研究放大镜及显微镜对口腔技师实操应用时的人体工程学影响,对比裸眼、放大镜及显微镜工作条件下技师的工作姿势,从人体工程学的人体姿势评价指标对放大镜及显微镜工具的实操应用价值进行对比评价。方法 在四川大学华西口腔医学技术教研室选择3名已熟练掌握放大镜及显微镜工具的技师,进行前瞻性随机对照试验。试验前在操作位置的矢状位、俯视位、背侧位分别安装相机设备,每人依次在裸眼(A空白对照组)、3.5倍头戴式放大镜(B放大镜组)和9倍技工显微镜(C显微镜组)下,瓷贴面采用椅旁计算机辅助设计(CAD)与计算机辅助制造(CAM)设备切削底层+饰面的设计方案,按照标准流程分别完成5颗右上中切牙瓷贴面的制作,全程通过录像完成姿势记录。每次操作完成后,采用OpenPose对视频数据的人体姿态进行识别,而后使用MATLAB计算上肢工作姿势中手臂、手肘、手腕、颈部及躯干角度等各关节角度,计算对应的快速上肢评估(RULA)分值,同时结合记录的实操时间进行人体工程学优势评价,采用SPSS 26.0统计学软件对汇总数据进行统计分析。结果 人体上肢关节角度分析结果显示,裸眼组的手臂、手肘、手腕、颈部及躯干角度分别为14.93°±9.44°、120.19°±2.99°、23.97°±2.84°、47.27°±5.72°及7.76°±2.30°,上述各关节角度在3组间的差异均具有统计学意义(P<0.05);与裸眼组相比,颈部及躯干角度在放大镜组分别降低了29.09%和42.53%,在显微镜组明显分别下降了43.99%和87.11%。通过LSD方法进行多重比较,在颈部角度与躯干角度中,裸眼组和放大镜组间的差异有统计学意义(P<0.05),裸眼组和显微镜组间的差异有统计学意义(P<0.05),放大镜组和显微镜组间的差异也具有统计学意义(P<0.05)。RULA分值分析结果显示,裸眼组、放大镜组和显微镜组的RULA平均值分别为(6.24±0.34)、(5.53±0.35)、(3.31±0.19)分;与裸眼组相比,放大镜组的RULA平均值降低,显微镜组的RULA平均值显著降低,各两组间的差异均有统计学意义(P<0.05);显微镜组的RULA平均值比放大镜组的显著降低(P<0.05)。实操时间的分析结果显示,裸眼组、放大镜组和显微镜组的平均实操时间分别为(50.69±36.78)、(52.01±34.65)及(59.44±35.81)min,3组间的差异无统计学意义(P>0.05)。结论 放大镜和显微镜均能改善口腔技师实操时的人体工作姿势,在有利技师的人体工程学便利上,显微镜有更好的效果。

关键词: 放大镜, 显微镜, 人体工程学, 口腔技师, 瓷贴面, 肌肉骨骼疾病

Abstract:

Objective This work aimed to study the effects of loupes and microscopes on a dental technician’s working posture during practical operation from ergonomic aspects. The technician's working postures under the conditions of the naked eye, loupes, and microscopes were compared. The practical value of loupes and microscopes was assessed based on the evaluation index of working posture from ergonomic aspects. Methods Three dental technicians who were skilled in using loupes and microscopes from West China Stomatology Technology Department of Sichuan University were involved in this prospective rando-mized controlled trial. Before the operation, cameras were installed in the sagittal position, top-view position, and dorsal position of the operation. Each technician made five porcelain veneers of the right maxillary central incisor following the standard process. A chairside computer-aided design and computer-aided manufacturing (CAD/CAM) system was used to mill and layer the ceramic block under the naked eye (A: control group), 3.5× headwear loupes (B: loupe group), and 9× desktop microscopes (C: microscope group). The working posture was recorded by videos throughout the entire process. After each operation, the investigator used OpenPose to recognize the working posture. The joint angles of the arm, elbow, wrist, neck, and trunk, as well as their corresponding rapid upper limb assessment (RULA) scores, were calcula-ted by MATLAB. The working posture was assessed from ergonomic aspects based on the joint angles, RULA scores, and operation time. Statistical analysis was performed using SPSS 26.0. Results The RULA score of upper limb joint angles showed that the angles of the arm, elbow, wrist, neck, and trunk under the naked eye were 14.93°±9.44°, 120.19°±2.99°, 23.97°±2.84°, 47.27°±5.72°, and 7.76°±2.30°, respectively. All of the joint angles were significantly different among the three groups (P<0.05). Compared with the control group, the angles of the neck and trunk in the loupe group were reduced by 29.09% and 42.53%, respectively, whereas those in the microscope group were significantly reduced by 43.99% and 87.11%, respectively. Multiple comparisons by LSD for the angles of neck and trunk revealed that the loupe group and the microscope group were significantly different from the control group (P<0.05), and they were also significantly different from each other (P<0.05). The mean RULA scores were 6.24±0.34 in the control group, 5.53±0.35 in the loupe group, and 3.31±0.19 in the microscope group. Compared with the control group, the mean RULA score in the loupe group was lower, and that in the microscope group was significantly lower. The differences between every two groups were statistically significant (P<0.05). The mean RULA score in the microscope group was significantly lower than that in the loupe group (P<0.05). The average operation times of the control group, loupe group, and microscope group were (50.69±36.78), (52.01±34.65), and (59.44±35.81) min, respectively. No significant difference was found among the three groups (P>0.05). Conclusion Use of loupes and microscopes showed an improvement in ergonomics and working posture of dental technicians. Microscopes had a better effect in the ergonomic convenience of the technician than loupes.

Key words: loupes, microscopes, ergonomics, dental technicians, porcelain veneers, musculoskeletal disorders

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