A Novel Ergonomic Curette Design Reduces Dental Prophylaxis-Induced Muscle Work and Fatigue.

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.

A novel technique for a difficult breech delivery.

BACKGROUND: Breech presentation and delivery are important complications of labor and delivery, which, although dealt with by the emergency physician infrequently, can represent major morbidity and mortality to both the mother and fetus if techniques are not performed correctly. OBJECTIVES: We aim to describe a technique for breech delivery that was used successfully when all conventional techniques had failed. To our knowledge, this technique has not been described in previous literature. CASE REPORT: A 36-year-old woman presented to an urban emergency department in active labor. The physicians were called to the triage area, and found the patient lying on the floor with a limp, cyanotic-appearing fetus delivered to the level of the mid thorax. The arms and shoulders were delivered successfully, but after all traditional maneuvers to deliver the head were unsuccessful, a novel approach was used successfully and is described in this report. CONCLUSION: We have described a novel, seemingly safe, and effective technique to use in breech delivery when traditional techniques have failed.