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Assessment of the ergonomic risk from saddle and conventional seats in dentistry: A systematic review and meta-analysis.

ABSTRACT: OBJECTIVE:This study aimed to verify whether the saddle seat provides lower ergonomic risk than conventional seats in dentistry. METHODS:This review followed the PRISMA statement and a protocol was created and registered in PROSPERO (CRD42017074918). Six electronic databases were searched as primary study sources. The "grey literature" was included to prevent selection and publication biases. The risk of bias among the studies included was assessed with the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. Meta-analysis was performed to estimate the effect of seat type on the ergonomic risk score in dentistry. The heterogeneity among studies was assessed using I2 statistics. RESULTS:The search resulted in 3147 records, from which two were considered eligible for this review. Both studies were conducted with a total of 150 second-year dental students who were starting their laboratory activities using phantom heads. Saddle seats were associated with a significantly lower ergonomic risk than conventional seats [right side (mean difference = -3.18; 95% CI = -4.96, -1.40; p < 0.001) and left side (mean difference = -3.12; 95% CI = -4.56, -1.68; p < 0.001)], indicating posture improvement. CONCLUSION:The two eligible studies for this review provide moderate evidence that saddle seats provided lower ergonomic risk than conventional seats in the examined population of dental students.

SUBMITTER: Gouvea GR

PROVIDER: S-EPMC6296655 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Assessment of the ergonomic risk from saddle and conventional seats in dentistry: A systematic review and meta-analysis.

Gouvêa Giovana Renata GR Vieira Walbert de Andrade WA Paranhos Luiz Renato LR Bernardino Ítalo de Macedo ÍM Bulgareli Jaqueline Vilela JV Pereira Antonio Carlos AC

PloS one 20181217 12

<h4>Objective</h4>This study aimed to verify whether the saddle seat provides lower ergonomic risk than conventional seats in dentistry.<h4>Methods</h4>This review followed the PRISMA statement and a protocol was created and registered in PROSPERO (CRD42017074918). Six electronic databases were searched as primary study sources. The "grey literature" was included to prevent selection and publication biases. The risk of bias among the studies included was assessed with the Joanna Briggs Institute ...[more]

PMID: 30557311

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Project description:Introduction:Dental practitioners are exposed to different occupational hazards during the course of their professional activity, such as physical, chemical, biological, ergonomic factors. The ergonomic hazards, caused by strained posture and prolonged repetitive movements, can induce musculoskeletal disorders. It occurs in 54-93% of dental professionals and involve the spine, shoulder and hand-wrist tract. Through a systematic review of international literature, we analyzed specific ergonomic risk factors and preventive measures of musculoskeletal disorders in professional dental activity. Methods:This systematic review is coherent with the PRISMA statement. The scientific research on the major online databases was based on the following keywords: dentist, prevention, ergonomic, dentistry, musculoskeletal, neck pain, posture, ergonomics, work and occupational. The studies included in this review focus on disorders related to ergonomics and on the most effective preventive measures to be adopted. No restrictions were applied for language or publication type. We excluded reports not related to ergonomic prevention in dentistry, reports of minor academic significance, editorial articles, individual contributions, and studies published in scientific conferences. Results:Online research indicated 4188 references: PubMed (2919), Scopus (1257) e Cochrane Library (12). We excluded 3012 of these, because they were unrelated to ergonomics theme and 187 due to duplication. From the remaining 989 studies, 960 papers did not meet inclusion criteria and they were excluded. Therefore, we analyzed 29 articles, including 16 narrative reviews and 13 original article. The main risk factor for the development of musculoskeletal disorders found in our analysis is static posture adopted during work, highlighted in 87.5% of reviews and 84% of original articles. With regard to preventive measures, 75% of the reviews highlighted the importance of stretching after each working session and at the end of the working day, while 61.5% of the original articles emphasized the use of modern and ergonomic instruments. Discussion:This review showed that static postures are strongly responsible in the etiology of musculoskeletal disorders. The awkward postures more frequently identified among dental professionals are: extreme forward-head and neck flexion; trunk inclination and rotation towards one side; lifting one or both shoulders; increased curvature of the thoracic vertebral column; incorrect positioning of the lower limbs with thigh-leg angle of less than 90°. It is really important to use of a modern workstation with appropriate ergonomic supports. Among the preventive ergonomic measures, literature has widely recognized the role of physical activity and of a neutral and balanced posture. The present review has some limits: a large part of the selected studies did not have a high methodological quality score and an inadequate statistical analysis.

Project description:The management of patients who undergo dental surgical procedures and receive oral anticoagulant therapy requires particular attention due to the risk of bleeding that may occur during the procedure. Bleeding rates in these trans- or post-operative patients tend to be unpredictable. The aim of this study was to conduct a systematic review in order to assess the risk of bleeding during and after performing oral surgery in patients administered oral anticoagulants compared with a group that discontinued anticoagulant therapy. For the purposes of this review, we searched the databases of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (via Ovid), EMBASE (via Ovid), and the Virtual Health Library (VHL) from inception of the database to December 2018. The primary outcome was defined as the occurrence of local bleeding during and after oral surgical procedures. Four reviewers, independently and in pairs, screened titles and abstracts for full-text eligibility. Data regarding participant characteristics, interventions, and design and outcomes of the included studies were extracted. The data were pooled using random-effects meta-analyses and described as risk ratios (RRs) with a 95% confidence interval (95% CI). The confidence for the pooled estimates was ascertained through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, and the protocol of this review was recorded in PROSPERO (CRD42017056986). A total of 58 eligible studies were identified, of which three randomized controlled trials were included in the meta-analysis, covering a total of 323 adult participants, among whom 167 were taking anticoagulants at the time they underwent dental surgery. Of these patients, 14.2% had reported bleeding. The risk of bleeding was found to be one to almost three times greater in patients taking warfarin compared with patients who discontinued the use of anticoagulant during the trans-operative period (RR = 1.67, 95% CI = 0.97 to 2.89) and in the post-operative period (RR = 1.44, 95% CI = 0.71 to 2.92), although the quality of evidence was very low. The results indicate that there is no evidence that the use of anticoagulants eliminates the risk of bleeding during surgical dental procedures.

Project description:Various financial and non-financial conflicts of interests have been shown to influence the reporting of research findings, particularly in clinical medicine. In this study, we examine whether this extends to prognostic instruments designed to assess violence risk. Such instruments have increasingly become a routine part of clinical practice in mental health and criminal justice settings. The present meta-analysis investigated whether an authorship effect exists in the violence risk assessment literature by comparing predictive accuracy outcomes in studies where the individuals who designed these instruments were study authors with independent investigations. A systematic search from 1966 to 2011 was conducted using PsycINFO, EMBASE, MEDLINE, and US National Criminal Justice Reference Service Abstracts to identify predictive validity studies for the nine most commonly used risk assessment tools. Tabular data from 83 studies comprising 104 samples was collected, information on two-thirds of which was received directly from study authors for the review. Random effects subgroup analysis and metaregression were used to explore evidence of an authorship effect. We found a substantial and statistically significant authorship effect. Overall, studies authored by tool designers reported predictive validity findings around two times higher those of investigations reported by independent authors (DOR=6.22 [95% CI=4.68-8.26] in designers' studies vs. DOR=3.08 [95% CI=2.45-3.88] in independent studies). As there was evidence of an authorship effect, we also examined disclosure rates. None of the 25 studies where tool designers or translators were also study authors published a conflict of interest statement to that effect, despite a number of journals requiring that potential conflicts be disclosed. The field of risk assessment would benefit from routine disclosure and registration of research studies. The extent to which similar conflict of interests exists in those developing risk assessment guidelines and providing expert testimony needs clarification.

Project description:The number of smartphone users globally is rapidly increasing. This study aimed to assess the level of ergonomic risk to smartphone users, and to evaluate the correlation between any self-reported musculoskeletal disorders and the level of ergonomic risk. Thirty participants completed a questionnaire, tailored specifically for smartphone users, to determine any musculoskeletal disorders. Participants were given a seated smartphone texting task and their postures were video recorded during the task. The video scenarios were evaluated by three independent researchers to determine the level of ergonomic risk using the Rapid Upper Limb Assessment (RULA) tool. RULA is an observation-based screening tool which has been widely used to assess the postural risk of IT device users. However, it has not yet been specifically utilized with smartphone users. The RULA tool scores identified ergonomics risks from using smartphones to text. Most smartphone users had a total RULA Grand Score of 6 for both sides (left side: 80.00%, right side: 90.00%), indicating the need for further investigation and changes (Action Level 3). Notably, no participants had acceptable RULA Grand Scores of 1 or 2. The correlation between musculoskeletal disorders and the ergonomic risk among smartphone users was determined using the Chi-Square test and Fisher's exact test; p<0.05 was considered statistically significant. There was a significant correlation between right RULA Grand Score and neck musculoskeletal disorder (χ2 = 9.424 at p value = 0.009) and right RULA Grand Score and upper back musculoskeletal disorder (χ2 = 31.717 at p value <0.001). RULA Score B (combination of neck, trunk and leg postures) and RULA Score D (combination of Score B, muscle use and force scores for group B) were also significantly correlated with neck musculoskeletal disorders (χ2 = 19.286 at p value<0.001 and χ2 = 9.310 at p value = 0.002 respectively). The RULA results identified the high ergonomics risk of smartphone users, this resulted from two key risk factors: posture and muscle use. The neck, trunk and leg postures had a combined effect on neck musculoskeletal disorders. Future investigations should consider these factors when designing ergonomic interventions for smartphone users.

Dataset Information

Assessment of the ergonomic risk from saddle and conventional seats in dentistry: A systematic review and meta-analysis.

Publications

Assessment of the ergonomic risk from saddle and conventional seats in dentistry: A systematic review and meta-analysis.

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