Концепція організації стоматологічної команди при роботі в шість рук: нова ергономічна модель клінічної та координаційної взаємодії

Olga Golinka

doi:10.33295/1992-576X-2026-3-DCOE-1

Authors

Olga Golinka Dentist, Sole Proprietor, 34/51 Ronald Reagan St., Kyiv, Ukraine

DOI:

https://doi.org/10.33295/1992-576X-2026-3-DCOE-1

Keywords:

ergonomics, dentistry, dental team, six-handed dentistry, clinical pair, coordination assistant, infection control

Abstract

Background. The rapid advancement of modern dentistry, alongside the widespread adoption of digital technologies, operating microscopes, cone-beam computed tomography, intraoral scanning, photographic protocol, and digital medical documentation, has significantly altered the management of dental appointments. Along with clinical procedures, the volume of associated non-clinical workflows requiring concurrent execution during patient care has grown substantially. Concurrently, most existing ergonomic models remain grounded in the classic four-handed dentistry concept, which fails to account for contemporary information, logistical, and organizational demands.

Aim. To develop a conceptual model for organizing a dental team in a six-handed operating environment through the functional allocation of clinical, logistical, information, and communication processes among team members, and to propose a novel ergonomic model of workspace zoning.

Materials and Methods. The concept was developed based on an analysis of scientific literature, international ergonomic models of dental appointments, the author’s previous research on ergonomics and team interaction, as well as extensive clinical and educational experience.

Results. A concept of dental team organization for six-handed dentistry is proposed, comprising three distinct functional roles: the dentist, the clinical assistant, and the coordination assistant. The term “clinical pair” is introduced to define the core clinical unit of the treatment process. A novel functional role for the coordination assistant is presented, responsible for logistical, information, and communication support without entering the operative field. Furthermore, a dynamic movement zone for the coordination assistant is designed to supplement the classic ergonomic zoning of the dental operatory.

Conclusions. The proposed model expands upon the classic four-handed dentistry concept, adapting it to modern clinical reality. The functional division of responsibilities between the clinical pair and the coordination assistant enhances treatment efficiency, ensures continuity of the clinical workflow, optimizes logistics, and improves adherence to the principles of asepsis and infection control.

Downloads

Download data is not yet available.

Author Biography

Olga Golinka, Dentist, Sole Proprietor, 34/51 Ronald Reagan St., Kyiv, Ukraine

ORCID: https://orcid.org/0009-0009-7780-9768

References

Murphy, D. C. (Ed.). (1998). Ergonomics and the dental care worker. American Public Health Association.

Valachi B., & Valachi K. (2003). Preventing musculoskeletal disorders in clinical dentistry: Strategies to address the mechanisms leading to musculoskeletal disorders. J Am Dent Assoc, 134(12), 1604–1612. DOI: https://doi.org/10.14219/jada.archive.2003.0106

Finkbeiner, B. L. (2001). Four-handed dentistry: A handbook of clinical application and ergonomic concepts. Prentice Hall.

Bird, D. L., & Robinson, D. S. (2023). Modern dental assisting (14th ed.). Elsevier.

Holinka, O., & Mochalov, Y. (2025). Ergonomics in dentistry: A science that prolongs professional activity. DentArt, (2), 62–67. [Голінка О. П., Мочалов Ю. Ю. (2025). Ергономіка у стоматології: наука, що подовжує професійну діяльність. ДентАрт, 2, 62–67]. [in Ukrainian].

Holinka, O. P. (2025). Ergonomic foundations of dental appointments]. DentArt, (4), 63–69. [Голінка О. П. Ергономічні основи стоматологічного прийому. ДентАрт, 4, 63–69]. [in Ukrainian].

Dalai, D. R., Bhaskar, D. J., Agali, C. R., et al. (2014). Four-handed dentistry: An indispensable part for efficient clinical practice. International Journal of Advanced Health Sciences. 1(1), 16–20.

Golinka, O., & Melikova, K. (2025). Formation of Professional Motivation of Dental Assistants. Actual Dentistry, (5), 52–59. [Голінка O., & Мелікова K. (2025). Формування професійної мотивації асистентів стоматолога. Cучасна стоматологія, (5), 52–59]. DOI: https://doi.org/10.33295/1992-576X-2025-5-52 [in Ukrainian].

Association of periOperative Registered Nurses. (2020). Consider a career in the OR. AORN Career Center. URL: https://www.aorn.org/article/consider-a-career-in-the-or

Association of periOperative Registered Nurses. (2018). Position statement: Perioperative registered nurse circulator dedicated to every patient undergoing an operative or other invasive procedure. AORN Journal.

Kohn, W. G., Collins, A. S., Cleveland, J. L., et al.(2003). Guidelines for Infection Control in Dental Health-Care Settings—2003. MMWR Recomm Rep, 52(RR-17), 1–61. DOI: https://doi.org/10.14219/jada.archive.2004.0019

Spaulding, E. H. (1968). Chemical disinfection of medical and surgical materials. In C. A. Lawrence & S. S. Block (Eds.), Disinfection, sterilization, and preservation, 517–531. Lea & Febiger.

Association for the Advancement of Medical Instrumentation. (2017). ANSI/AAMI ST79: Comprehensive guide to steam sterilization and sterility assurance in health care facilities.

International Organization for Standardization. (2006). Sterilization of health care products — Moist heat — Part 1: Requirements for the development, validation and routine control of a sterilization process for medical devices (ISO Standard No. 17665-1:2006).

International Organization for Standardization. (2006–2018). Washer-disinfectors (ISO Standard No. 15883 all parts).

International Organization for Standardization. (2019). Packaging for terminally sterilized medical devices — Part 1: Requirements for materials, sterile barrier systems and packaging systems (ISO Standard No. 11607-1:2019).

International Organization for Standardization. (2014). Sterilization of health care products — Chemical indicators — Part 1: General requirements (ISO Standard No. 11140-1:2014).

Ministry of Health of Ukraine. (2014, August 11). On approval of State Sanitary Norms and Rules “Disinfection, pre-sterilization cleaning and sterilization of medical devices in healthcare facilities” (Order No. 552). [Міністерство охорони здоров’я України. (2014, 11 серпня). Про затвердження Державних санітарних норм та правил «Дезінфекція, передстерилізаційне очищення та стерилізація медичних виробів в закладах охорони здоров’я» (Наказ № 552)]. URL: https://zakon.rada.gov.ua/laws/show/z1067-14

Ministry of Health of Ukraine. (2024, October 31). On approval of State Sanitary Norms and Rules “Procedure for medical waste management, including safety requirements for human health during the generation, collection, storage, transportation, and treatment of such waste” (Order No. 1827). [Міністерство охорони здоров’я України. (2024, 31 жовтня). Про затвердження Державних санітарних норм та правил «Порядок управління медичними відходами, у тому числі вимоги щодо безпечності для здоров’я людини під час утворення, збирання, зберігання, перевезення, оброблення таких відходів» (Наказ № 1827)]. URL: https://zakon.rada.gov.ua/laws/show/z1827-24

Centers for Disease Control and Prevention. (2016). Summary of infection prevention practices in dental settings: Basic expectations for safe care. U.S. Department of Health and Human Services. URL: https://www.cdc.gov/oralhealth/infectioncontrol/pdf/safe-care-guides.pdf

World Health Organization. (2009). WHO guidelines on hand hygiene in health care. URL: https://www.who.int/publications/i/item/9789241597906

World Health Organization. (2016). Decontamination and reprocessing of medical devices for health-care facilities. URL: https://www.who.int/publications/i/item/9789241549851

Rutala, W. A., & Weber, D. J. (2008). Guideline for disinfection and sterilization in healthcare facilities, 2008. Centers for Disease Control and Prevention; Healthcare Infection Control Practices Advisory Committee.

Ministry of Health of Ukraine. (2021, August 3). On the organization of infection prevention and control in healthcare facilities and institutions/facilities providing social services/social protection of the population (Order No. 1614). [Міністерство охорони здоров’я України. (2021, 3 серпня). «Про організацію профілактики інфекцій та інфекційного контролю в закладах охорони здоров’я та установах/закладах надання соціальних послуг/соціального захисту населення» (Наказ № 1614)]. URL: https://zakon.rada.gov.ua/laws/show/z1318-21