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The Concepts of Four-handed Dentistry Including Ergonomic Instrument Transfer and Exercises for Stress Reduction

Course Number: 643

Zones of Activity

All treatment activity evolves around the patient. Before equipment selection can be considered, the dental team must be aware of spatial relationships around the patient at chairside. The work area around the patient is divided into four “zones of activity.” Zones of activity are identified using the patient’s face as the face of a clock. The four zones are: the operator’s zone, assistant’s zone, transfer zone, and static zone.1,5

Zones of Activity - Figure 1

Zones of Activity for a Right-handed Dentist.

Zones of Activity - Figure 2

Zones of Activity for a Left-handed Dentist.

The operator’s zone for a right handed operator extends from 7 to 12 o’clock, the assistant’s zone from 2 to 4 o’clock, the instrument transfer zone from 4 to 7 o’clock, and the static zone from 12 to 2 o’clock.1 The operator changes position dependent upon the dental arch and tooth being treated. The assistant seldom moves much in the zone of activity but may find it necessary to raise the operating stool when working on the mandibular arch to improve the line of sight into the oral cavity.

These zones are self-explanatory except for the static zone. It is called the static zone but could be renamed the set-up zone. This is where the tray set up will be located for the assistant to retrieve the instruments, materials, and small equipment used during the patient procedure. There may be an additional countertop space in this area. Instruments such as a timer or curing light can be accessible in this area.

An awareness of the zones of activity is important as they serve as guides for the dental team in locating equipment as well as positioning the patient and operating team to facilitate access to the operative field and improve visibility.