Instruments of the orthopedic department
Wheel-shaped and fissure burs for removing metal crowns, diamond burs for preparing hard tooth tissues. Disk holders. Carborundum stones and heads. Disks separating metal and carborundum.
Metal and carborundum cutters of various styles for the correction of a plastic prosthesis.
When treating a patient, it is important to give him a position in which he would sit freely, without tension, and at the same time, this position was convenient for the doctor. For this purpose, a dental chair is used, equipped with mechanisms that can be used to recline the back of the chair and give the patient a lying position, which creates the best conditions for the doctor to manipulate in the oral cavity and the ability to work with the assistant dentist, who is located to the left of the patient.
If the patient lies in the dental chair, this provides a good overview of all quadrants of the jaws, which allows you to work freely and without tension, being in close proximity to the recumbent patient.
The correspondence of tools and the environment to the anatomical, physiological and psychological capabilities of the human body is one of the principles of ergonomics (ergos – work, nomos – law). When we talk about the ergonomic organization of the work of a medical worker, we put many points into this concept.
1. Equipment, work furniture, work clothes and tools take into account anthropometric measurements and the anatomical and physical characteristics of the body of a medical worker in accordance with the requirements of technical aesthetics, occupational health and safety.
2. Dental rooms and workrooms are rationally arranged on the basis of scientifically based standards for their area, height, depth, cubic capacity, sanitary and technical improvement, interior decoration. The most suitable is a combination of furniture in the shape of the letter U.
3. Optimal organization of the personnel workplace by placing equipment, taking into account anthropometric data and the possibility of adjusting individually for height, the correct choice of working posture, work movements, mechanization and automation of medical and diagnostic equipment, the correct placement of control and signaling devices on instruments and units.
4. Proper organization of the regime of work and rest, study of occupational factors, including those harmful to health, prevention of occupational diseases. Ergonomics affects the improvement of dental instruments and the facilitation of working with them:
– standardization, which helps to reduce the number of tools;
– special stacking of instruments, convenient for the work of a doctor and a nurse (tray system);
– design of instrument handles, taking into account the anatomical and physiological features of the doctor’s working hand;
– color marking of tool handles with minimum dimensions of working parts to facilitate their identification;
– appropriate modes of storage, disinfection and sterilization.
5. In the process of treating a dental patient, various sets of instruments are used. However, there is a constant set of tools with which the initial examination and subsequent treatment of the patient is carried out. This set includes: dental mirror, dental tweezers, angle probe, metal spatula.
Organization of a dental laboratory
As a rule, the orthopedic department and the prosthetic laboratory are located on the same floor.
The independent rooms of the laboratory are: the main, gypsum, molding and polymerization, soldering, foundry. It is permissible to combine gypsum, molding and polymerization in one room.
Main, or blank room . This room is designed to perform the main processes for the manufacture of dentures (modeling, setting teeth, finishing dentures, etc.). The height of the working room must be at least 3 meters. Each worker must have at least 13 m 3 of production space and at least 4 m 2 of area.
The walls of the main room of the laboratory should be painted with light-colored oil paint to facilitate maintenance. The floors must be covered with linoleum. Windows must meet a number of sanitary and hygienic requirements: 1) the light coefficient (the ratio of the glazed window surface to the floor area) is provided for at least 1/5 ; 2) windows should be located at an equal distance from each other and from the corners of the building; 3) the upper edge of the window should be as close as possible to the ceiling (20-30 cm); 4) window sashes should be narrow and sparse, it is better if they are solid glass; 5) the permissible angle of incidence of light rays formed by a beam of light and a horizontal plane, i.e. its inclination to the horizon, in the workplace at least 25-27 degrees; 6) workplaces should be located so that the light falls directly or from the left side of the worker; 7) the distance from the place of work to windows in rooms illuminated by natural side light should not exceed three times the distance from the floor of the room to the upper border of the window opening, the maximum width illuminated by windows on both sides of the room should be practically 15-18 meters.
Gypsum room . All work related to plaster is carried out in the plastering room: casting models, plastering in an occluder, plastering prostheses in cuvettes before polymerization, releasing prostheses from plaster molds, etc.
Molding and polymerization room . In this room, plastic is prepared, molded and polymerized.
Polishing room . This room houses tables with several loop motors for polishing prostheses made of metals and alloys.
The soldering room is equipped with one or more fume hoods, where soldering machines are installed, equipped with compressors for automatic supply of gasoline. In cabinets, soldering of individual parts of test runs is carried out, bleaching them after soldering.
Foundry room . For high-quality manufacturing of modern designs of prostheses, such as bridge-like, metal-ceramic, clasp, etc., individual casting is required, where the components of such prostheses are cast according to investment molds individually for each patient.
Room for work with cermets and precious metals . Introduction to the wide orthopedic practice of manufacturing prostheses from porcelain, cermets, precious metals requires special equipment and materials. This is, first of all, an electric furnace with program control. A vacuum mixer is used to knead the molding paste to cover the wax compositions of the models.
To free the cast parts from the remains of the molding material, scale and prepare their surface for final finishing, a special sandblasting unit is used in the dental laboratory.
In the dental office, an area of at least 14 m 2 (4.3×3.3 m) should be allocated for one workplace. For each additional chair, 7 m 2 is added. At the same time, the number of additional chairs in the office should not exceed two, i.e. in total, the office should be designed for three chairs, and its area should be at least 28 m 2 . However, if the chair has a modern dental unit, then not 7 m 2 , but 10 m 2 of area relies on an additional chair, and the total area of u200bu200bthe office for 3 chairs increases to 34 m 2 . The height of the dental office should be at least 3 m in order to provide at least 12 m 3 of air per person. The depth of the room should not exceed 6 m, as this affects the natural lighting conditions of workplaces. If this parameter exceeds 6 m, then dental chairs can be placed in two rows. In treatment rooms and premises of the dental laboratory, there should be separate sinks for washing the hands of personnel, special sinks for other production purposes. A table for sterile materials and instruments is required.
The walls must be smooth, without cracks and crevices; corners and junctions of walls, ceiling and floor should be rounded; the ceilings are smooth and painted white. To the height of the doors, the walls are painted with alkyd styrene, polyvinyl citate, oil paints or light-colored nitro enamel. Above the panel is painted with silicate or glue paints. The floors are laid with rolled polyvinyl chloride material (linoleum, vinyl plastic), the seams are welded. Doors and windows are painted with white enamels or oil paint to increase illumination due to reflected light. To maintain an optimal microclimate, dental clinics (rooms) are equipped with central water heating with a surface temperature of heating devices not exceeding 80°C. They are installed at the outer walls, under the windows, without fences. Surfaces of appliances should be smoothly painted, easy to wet clean and kept clean. General exchange supply and exhaust ventilation with mechanical stimulation is provided, the frequency of air exchange is 3 times per hour for the exhaust and 2 times per hour for the inflow. There should also be easily opening windows (transoms), local dust extraction from the polishing unit and electric grinder, exhaust hoods in the foundry above the centrifugal casting furnace, above the gas stove and the work table in the polymerization room. In order to normalize the microclimate, the use of household air conditioners is shown. The average room temperature is 18-25°С, air humidity is 60-40%, air velocity is 0.2 m/s.
The windows of dental offices should be oriented to the northern points of the horizon (north-west, north, north-east). If the orientation is incorrect, it is recommended in the summer to darken the windows with curtains, blinds, awnings, etc. General artificial lighting should be provided in all rooms without exception, in addition, local lighting is arranged. General artificial lighting is carried out with incandescent lamps and fluorescent lamps (types LDC, LHE, equipped with ballasts with an especially low noise level); placed on the ceilings (not to fall into the field of view of the working doctor), must be with solid (closed) diffusers. For local lighting, a lamp of the DKSSh type is recommended, local lighting levels should be in the range of 2000-5000 lux.
There are additional requirements for a dental laboratory: the main (blank) room must have: a height of 3-3.5 m,
V-13 m 2 (for no more than 15 dental technicians, at the rate of 4 m 2 per person), the walls are smooth, painted, in special rooms the doors are lined with glazed tiles to the height, above the panels are painted with silicate or adhesive paints. The floor in the dental laboratory: in the main rooms – from linoleum, in special rooms – from ceramic tiles. Light coefficient – 1/5, the angle of incidence of light rays at the workplace is at least 25-27 °, the upper edge of the window should be as close as possible to the ceiling (20-30 cm), window sashes should be narrow, possibly more rare, workplace positioned so that the light falls directly or from the left side. Air temperature within 17-25, not more than 28°C, relative humidity 75-65%, air speed 0.2-0.3 m/s. The workplace of the dental technician in the main room should have:
– a special dental table;
– an electric grinder with local dust extraction, located on the left half of the table, on the same side there is local artificial lighting;
– gas supply (safe alcohol burners or electric heaters are acceptable), located on the right.
The main premises of the dental laboratory are necessarily equipped with fireproof cabinets (safes) built into the walls for storing gold items in operation.
The premises of the dental laboratory are equipped with a centralized supply system of compressed air, vacuum, oxygen, cold and hot water with mixer taps. Wastewater from gypsum sinks is freed from gypsum before being discharged into the sewer.