Research and Publications

Lin K, Wink C, Dolan B, Osann K, Habib AA, Gehrig J, Wilder-Smith P. A Novel Ergonomic Curette Design Reduces Dental Prophylaxis-Induced Muscle Work and Fatigue. Dent J. 2023 Nov 28;11(12):272. doi: https://doi.org/10.3390/dj11120272. PMID: 38132410; PMCID: PMC10742551.

Abstract

Background: To compare fatigue, comfort, and muscle work associated with the use of two periodontal curettes during scaling: one with a novel adaptive design, the other with a conventional non-adaptive design. Methods: Twelve hygienists scaled a typodont using two Universal Barnhart 5/6 curettes: (1) a prototype featuring an adaptive silicone-covered handle (Curette A), and (2) a stainless-steel curette (Curette B). Surface Electromyography (sEMG) traced muscle work. Hand positions, fatigue, comfort, pinch, and grasp strength were recorded. Paired t-tests and a repeated measures ANOVA with covariates were tested for differences. The significance level was set at p < 0.05. Results: Curette A performed significantly better in all categories. Pinch and grasp strength and fatigue were significantly reduced post-instrumentation for Curette B. Curette A required significantly less (i) total muscle work and (ii) work in individual muscles. Comfort, correct grasp, and blade adaptation were significantly better using Curette A. Conclusions: A curette featuring a novel adaptive handle design demonstrated significantly improved ergonomic performance. Additional clinical studies are needed to solidify our understanding of the potential short- and long-term benefits of the novel curette handle design. Practical Implications: A novel adaptive curette handle design that enables the clinician to adapt the instrument across the index finger may reduce musculoskeletal burden and fatigue, as well as improve comfort during periodontal instrumentation.

Wink C, Lin K, Dolan BE, Osann K, Habib AA, Wilder-Smith P. Evaluating the Ergonomic Performance of a Novel Periodontal Curette with Adaptive Handle Design. Hygiene. 2024; 4(2):164-177. https://doi.org/10.3390/hygiene4020013

Abstract

(1) Background: Periodontal instrumentation with dental curettes is associated with discomfort, fatigue, and musculoskeletal diseases. The goal of this study was to compare comfort, fatigue, and muscle work using three different curettes. (2) Methods: Eight hygienists each scaled three typodonts using the three different curettes. Curette A was a prototype with a novel adaptive design, Curette B had a conventional stainless-steel design, and Curette C featured a conventional silicon-covered handle. Time-based work in four muscles, comfort, fatigue, tactile feedback, grip and blade position, and pinch and grasp strength were recorded. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey’s post hoc test. The level of significance was set at p < 0.05. (3) Results: Comfort, correct grasp, fingertip placement, and blade-to-tooth adaptation were significantly better with Curette A (p < 0.05). While pinch and grasp strength were significantly reduced post-instrumentation for Curettes B and C (p < 0.05), they remained unchanged for Curette A. Curette A required significantly less total muscle work and work in individual muscles, resulting in significantly less post-instrumentation fatigue than for Curettes B and C, but similar levels of tactile feedback (p < 0.05). (4) Conclusions: The ergonomic performance of a prototype adaptive periodontal curette was significantly better than that of two conventional instruments with rigid handle designs.

Wink C, Yang SM, Habib AA, Lin K, Takesh T, Wilder-Smith P. Effect of a Novel Adaptive Handle Design on the Ergonomic Performance of Periodontal Curettes in Dental Hygienists with and without Musculoskeletal Disorders: A Pilot Clinical Study. Dentistry Journal. 2024; 12(8):253. https://doi.org/10.3390/dj12080253

Abstract

(1) Background: Musculoskeletal disorders (MSDs), discomfort, fatigue, pain, and other acute and chronic work-related injuries are common among dental clinicians. Hand instruments constitute a primary risk factor for these conditions. The overall goal of this study was to compare in dental hygienists with healthy hands, and in those with MSDs, the effect of three different handle designs on instrumentation-related muscle work, comfort, fatigue, and quality of tactile feedback. (2) Methods: Clinicians tested three periodontal curettes: one with a novel adaptive silicone handle, another with a rigid resin handle, and the third with a rigid silicone handle. Ten hygienists—five with MSDs and five without—each scaled three typodonts using the three different curettes. Statistical analysis was performed using a General Linear Model (GLIM) and Tukey’s post hoc test, and a significance level of p < 0.05 was implemented. (3) Results: On average, mean comfort and fatigue across all instruments were significantly worse in testers with MSDs, who also expended significantly more work to complete the same task. In all testers, a novel adaptive handle design was associated with significantly reduced total muscle work and post-instrumentation fatigue, as well as better comfort than conventional rigid handle designs. (4) Conclusions: An adaptive curette handle design demonstrated significantly better ergonomic outcomes than conventional rigid curette handle designs. Hygienists with MSDs expend significantly more muscle work during dental instrumentation.

Wink C. Adaptive Handle Design May Provide Ergonomic Benefits. RDH. June 2024 https://digital.rdhmag.com/rdhmag/202406/MobilePagedReplica.action?pm=2&folio=48#pg50

Summary

The researchers concluded that the ergonomic performance of a dental curette can be improved considerably beyond the benefits provided by a softer, larger diameter instrument handle  by replacing the conventional rigid handle with an adaptive handle design which allows the instrument to align closely with each user’s anatomical hand shape.

Wink C, Lin K, Dolan B, Norouzi T, Ilagan J, Osann K, Habib AA, Wilder-Smith P.  The Comparison of a Novel Curette Handle Design to a Stainless-Steel Handle on Hand and Arm Fatigue when Scaling. Annual Meeting of the ADHA, 2021.

Summary

Researchers concluded from this randomized cross-over clinical study that a curette featuring a novel adaptive, silicon-surfaced handle design demonstrated significantly improved ergonomic performance as compared to a conventional stainless-steel curette.

Novel Curette Design Reduces Dental Prophylaxis-Induced Work and  Improves Comfort. Wink C, Lin K, Dolan B, Norouzi T, Jun J, Osann K, Habib AA, Wilder-Smith P. Annual Meeting of the IADR, 2021. 

Summary

This clinical study compared the ergonomic performance of a rigid stainless steel dental curette vs a novel silicone-covered adaptive design. The prototype instrument performed significantly better in all categories, with an average reduction in muscle fatigue of 30-50%. Comfort was 80% better, and hygienists implemented correct grasp 35% more often and optimal blade adaptation 75% more often using the adaptive instrument. Pinch and grasp strength were significantly reduced after a standard instrumentation protocol for the conventional curette (mean 19%) but not for the instrument with the adaptive handle (mean 9%). A novel adaptive handle curette handle design significantly improved ergonomic performance during instrumentation by reducing work and fatigue while improving comfort and supporting optimal technique.

Adaptive Curette Handle  Improves Ergonomic Performance, Comfort during Periodontal Instrumentation. Wink C, Dolan B, Takesh T, Habib AA, Wilder-Smith P. Annual Meeting of the IADR, 2024. 

Summary

This study compared the ergonomic performance of 4 different dental curette designs. An instrument featuring a novel adaptive handle design performed significantly better than conventional instruments with rigid handle design. Instrumentation-related muscle fatigue averaged 40%  less, total muscle work 55% less, individual muscle work 30-70% less, and comfort was 80% improved. Users implemented correct grasp 25% more often and optimal blade adaptation 40% more often using the adaptive curette. Pinch and grasp strength were significantly reduced post-instrumentation for curettes with rigid handles (mean 20%), but not for the adaptive curette (mean 7%). Adapting the curette handle to the clinician’s hand during periodontal instrumentation can significantly reduce work and fatigue while improving the clinician’s comfort and supporting ergonomic instrumentation techniques.