[0001] The present invention relates to the technical field of patient chairs used in dentistry.
More particularly, the invention relates to an apparatus according to the preamble
of claim 1 and a method according to the preamble of claim 9 allowing patient chair's
movements.
[0002] In the history of dentistry, until at least 1960s, dentists used to work standing,
while today dentists work mainly sitting. Dental chair manufacturers strive to provide
dental treatment units allowing the dentist to work ergonomically, i.e. comfortably,
without damaging dentist's musculoskeletal system.
[0003] At the same time, patient chairs must be comfortable for patients: comfortable patients
are more relaxed, and for dentists working is easier.
[0004] An appreciated feature of dental patient chairs is the possibility of holding the
patient in Trendelemburg position. Trendelemburg position, or anti-shock position,
is the position wherein a patient is placed in case of shock or during the performance
of specific operations: the patient is supine, lying so that her/his head is lower
than her/his knees and pelvis, to help maintain blood flow to the brain. Moreover,
Trendelemburg position reclines patient's head allowing chest and legs to form an
angle, instead of having chest and legs aligned in a position that can be uncomfortable
for the patient. Trendelemburg position eases dentist's work in performing some kind
of therapies.
[0005] A problem linked to the reclining of backrest is that while the backrest reclines,
patient's head, on which the dentist operates, progressively relocates in space, from
a position substantially aligned with her/his hip joint, to a position wherein patient's
head is at a marked distance from patient's hip, say in the order of 50-70 cm. This
forces the dentist, normally positioned on patient's side or behind the patient, to
replace with respect to the room and the dental treatment unit along with backrest
reclining. Figures, particularly Figures 3 and 4, will help to better clarify this
effect.
[0006] Moreover, when the working position is aligned with the chair longitudinal axis,
and therefore the dentist is positioned behind patient's head, often when reclining
the chair no room is left for the dentist. Therefore, wide spaces become necessary
to accommodate the dental treatment unit and all the accessories and tools needed
by the dentist.
[0007] In the known art, there are two kinds of patient chairs:
- Patient chairs having the seat consisting in a unique part, whose only articulation
is at the level of patient's hip; this means that thighs and distal portion of legs
form a steady angle;
- Patient chairs having a two-part seat, having a first articulation at the level of
patient hip, and a second articulation at the level of patient knees. In these two-part
seat chairs, patients can seat upright as in any chair, with the distal leg portion
forming an angle of about 90° with respect to thighs. In this kind of chairs there
is a seat, which remains substantially parallel to the floor, from the leg-rest, which
can rotate from a positions substantially parallel to the floor, to a position substantially
perpendicular to the floor; i.e. the angle between thighs and distal portion of legs
is variable.
[0008] Manufacturers have industrially produced dental patient chairs for over a hundred
years; a known document is e.g.
EP0253943B1 of Castellini, wherein Trendelemburg position is reached through a hydraulic system.
Document
EP0253943 discloses a four bar linkage of the seat which is linked to the backrest by means
of a connecting link comprising two pivot connections and displacing the backrest
together with the seat by means of a common actuator.
[0009] Document
US3,934,929 discloses an arc bracket supporting the backrest and a sliding movement of the bracket.
This bracket is however not linked with a four-bar linkage for controlling the motion
of the seat.
[0010] The above-quoted patents, with many others, describes patient chair internal structure,
allowing the movement of the chair. In fact, while in use the chair has typically
a position wherein its backrest is at about 90° with respect to the floor (upright
position) and a position wherein the backrest is substantially parallel to the floor
(reclined position), with all the intermediate positons between said two extremities.
Said positions are obtained through a wide variety of relatively complex mechanisms
and actuators. Moreover, when modifying the law of relative motion between backrest
and seat, the replacement or alteration of parts of said mechanism is complex and
time-consuming, as it requires accessing and disassembling a high number of parts
of the kinematic chain of articulation between backrest and seat.
[0011] Aim of the present invention is providing a mechanism allowing to bring the backrest
from the upright position to the reclined position and vice versa, which is efficient
and cost-effective to manufacture.
[0012] A second aim of the present invention consists in limiting the dentist's relocation
connected to chair reclining. The mechanism of the present invention allows a backrest
movement that is coordinated with the seat, which shifts until it reaches an ergonomically
correct position for the patient, in case of need until the maximal extension in Trendelemburg
position. In other words, during the reclining of the backrest, there is also a shifting
of the backrest towards patient's feet of the backrest itself and contextually of
the seat too, to compensate the sheer shift due to backrest reclining, would it be
hinged to a stationary pivoting axis. This has the aim of maintaining as much as possible
patient's head in the same position as when patients seats upright (longitudinal compensation
movement). This movement allows to maintain the relative patient's head position with
respect to water group, instruments table and operating lamp and with respect to the
room (furniture and walls of the dental practice).
[0013] A further aim is obtaining a chair structure having a manufacturing modularity:
- Simple patient chair having 1) Trendelemburg position obtained through backrest reclining,
wherein longitudinal compensation movement is absent;
- Patient chair with unique-part seat, reaching 1) Trendelemburg position and 2) longitudinal
compensation;
- Patient chair with two-part seat comprising 1) Trendelemburg position, 2) longitudinal
compensation, 3) relative movement between seat and leg-rest.
Starting from the same basic structure for lifting the chair and adding the structure
seat-backrest, modifying the system of movement of the structure seat-backrest, and
applying some leverages, the performance of the patient chair can be differentiated
from low-end to high-end product. In this way, the client can be provided with a complete
range of performances with a reduced production cost, linked to the limitation of
production codes.
[0014] This object is achieved by an apparatus and a method having the features of the independent
claims. Advantageous embodiment and refinements are specified in the claims dependent
thereon.
[0015] Substantially the present invention consists in obtaining the backrest movement through
a combined arc prismatic guide system, through which the backrest is pivoted from
the substantially vertical position or upright position to the substantially horizontal
position or Trendelemburg position and vice versa. Moreover, the backrest is contextually
translated along the chair longitudinal axis, in the direction of the seat and in
the opposite direction, respectively, progressively and according to the tilting of
the backrest itself, while said oscillation/translation is combined with a corresponding
simultaneous translation of the seat, thanks to a four-bar linkage that moves said
seat. The arc prismatic guide system is dynamically connected to said four-bar linkage,
the assembly being actuated by an actuator only. Optionally, to these two components
a third mechanism is connected, which angularly moves the leg-rest with respect to
the fixed seat.
[0016] It is worth noting that in the preferred embodiment, the arc prismatic guide is centrally
positioned, symmetrically with respect to the longitudinal chair axis, and it allows
the articulation between the backrest and the fixed seat around an axis of rotation
corresponding with patient's hip.
[0017] In a not shown embodiment, a lateral prismatic guide can be used (positioned either
on the right or on the left side of the chair, or on both sides); nonetheless, this
configuration has the disadvantage of being more cumbersome, hindering the access
of the dentist to the patient in comparison to the preferred embodiment.
[0018] In an embodiment, the backrest has at least an arc bracket supporting on one end
the support of backrest upholstery, while its opposing end engages with a carriage
in an arc guide. Said arc guide is integral with the mobile structure with respect
to the turret, which is in turn hinged with the pantograph arm, while said end supporting
said at least one carriage is dynamically connected to at least one element of the
four-bar linkage to which the seat supporting frame is connected.
[0019] The dynamic connection between arc guide system, or particularly between the backrest
bracket and the four-bar linkage to which the seat is fastened, can be realized according
to different modalities, which can be chosen from the different motion transmission
system known by the skilled person.
[0020] According to an advantageous feature, a unique motorized actuator is dynamically
linked to an element of the prismatic guide system, and moves correspondingly the
four-bar linkage, and optionally the leg-rest moving mechanism, when this last is
present.
[0021] In particular, the four-bar linkage, the prismatic guide system, the connecting transmission
system between said prismatic guide system and four-bar linkage, and also the mechanism
moving the leg-rest and the dynamically connecting transmission system between leg-rest
and arc prismatic guide system, or the transmission between said system and the four-bar
linkage are produced as modular subassemblies which can be assembled as desired on
the structure of the chair, in particular on chair turret.
[0022] A first advantage of the present invention is the standardization of parts; with
a minimal number of additional, modular components, the chair can be provided with
more and more refined performances, going from a basic chair to a premium chair.
[0023] A further advantage is linked to the presence of a longitudinal compensation movement,
in that the position of the water group and of the dental treatment unit remains about
the same on the dentist's side, with any position of the backrest.
[0024] Further advantages and properties of the present invention are disclosed in the following
description, in which exemplary embodiments of the present invention are explained
in detail based on the drawings:
- Figure 1
- Lateral view of a patient chair having its backrest in an upright position;
- Figure 2
- Lateral view of a patient chair having a completely reclined backrest in Trendelemburg
position;
- Figure 3
- Lateral view of a patient chair having its backrest in an upright position, showing
its leverages;
- Figure 4
- Lateral view of a patient chair having a completely reclined backrest in Trendelemburg
position, showing its leverages;
- Figure 5
- Lateral view of a patient chair having its backrest in an upright position, showing
a four-bar linkage;
- Figure 6
- Lateral view of a patient chair having its backrest in reclined position, showing
a four-bar linkage.
[0025] Figure 1 shows a typical dental patient chair 1 comprising a backrest 2, a fixed
part 3 of the seat hinged with a leg-rest 13, a base 4 and a pantograph arm 5. The
chair 1 is shown with an upright backrest, about perpendicular to the floor.
[0026] For simplicity's sake, a two-part seat chair is shown, having two articulations,
one at the level of patient's hip and one at the level of patient's knees: therefore,
the mobile leg-rest 13 can be hinged with the fixed part 3 of the seat. Anyway, the
operation remains the same even for a chair having a unique part seat 3.
[0027] The pantograph arm 5 allows the lifting and lowering of the seat 3, indicatively
from a height of 460 to 840 mm with respect to the floor. The top end of the pantograph
arm forms a sort of turret 14 supporting the reclining mechanism of the backrest and
coordinated movement of the seat. The structure of turret 14, base 4 and pantograph
arm 5 is known, and is not the object of the present invention.
[0028] Figure 2 shows the same chair 1 in Trendelemburg position, with completely reclined
backrest 2, about parallel to the floor. The reclining of backrest 2 from the upright
position shown in Figure 1 to the reclined position shown in Figure 2 occurs through
an arc prismatic guide. Comparing Figure 3 and 4 one can appreciate how, while reclining
the backrest 2, there is a longitudinal compensation movement, i.e. along the longitudinal
axis of the (not shown) patient, towards her/his feet.
[0029] In Figure 3 an arc of a circle simulates the movement of the head-rest and of the
backrest 3; in the absence of the compensation movement that is the object of the
present invention, patient's head would be in point K. Drawing the (dotted) vertical
extension of the K point, in Figure 4 it is shown that, with reclined chair, the distance
q from point K projected in point B, with respect to reference point P on the fixed
base of the chair is reduced thanks to the longitudinal compensation movement. In
other words, in the absence of the four-bar linkage object of the present invention,
when the backrest 2 is completely reclined, patient's head travels along an arc of
circle and ends in point K, which is at a distance k from the fixed reference point
P; said distance k corresponds to the cosine (Figure 3). Using the four-bar linkage
according to the present invention, seat 3 is instead translated towards patient's
feet, which compensates in the desired quantity, reducing the distance k, which becomes
the distance q shown in Figure 4. The compensation is Δ = k - q. To the skilled person
it is apparent that modifying the four-bar linkage, and particularly the length of
piston rods 6 and 6 and their angles, the distances k and q can be modified as desired.
[0030] Figures 5 and 6 allow to appreciate both the arc guide system moving the leg-rest
and the four-bar linkage in its entirety.
[0031] The backrest 2, at its end oriented towards the seat 3, has an arc-shaped bracket
102 connecting the backrest to the under seat 15 mobile with respect to the turret
14 hinged on the pantograph arm 5. The end of said arc bracket 102 is engaged through
e.g. a slide or a carriage in at least an arc guide integral to the turret and not
visible in the Figures.
[0032] A transmission connects the end of said arc bracket 102 provided with the carriage
with an element of the four-bar linkage controlling the movement of the seat, e.g.
with one of piston rods 6, 7 or with a shaft coinciding with one of the articulation
axis of the four-bar linkage.
[0033] The shifting of backrest 2 is dynamically connected to the shifting of the seat,
and thanks to the arc guide system, the backrest not only modifies its tilting, but
contextually progressively moves forward toward the seat with the progressive increase
in reclining, from substantially upright to substantially horizontal and back with
the tilting from substantially horizontal to substantially upright, while the seat
follows according to a pre-set relative law of motion the shifting of the backrest
in the chair longitudinal direction.
[0034] When a leg-rest 13 is present, it performs a combined pivoting and translating movement,
synchronised with the movement of backrest 2 and seat 3.
[0035] Substantially, said four-bar linkage o parallelogram comprises two piston rods 6
and 7, the fixed member turret 14 and mobile member under seat 15 (visible in Figure
6 only). The four-bar linkage articulates on the pivot pins 8, 9, 10, 11 positioned
on piston rods 6 and 7. In particular, pivot pins 8 and 9 are hinged on turret 14,
while pivot pins 10 and 11 are hinged on under seat 15, to which seat 3 is connected.
[0036] In Figure 6, with reclined chair, one can observe that piston rods 6 and 7, being
of different length, are about vertical, while piston rod 7 is in a higher position
than piston rod 6, so that the seat is inclined with its part towards patient's feet
higher than the part toward patient's head: this allows to obtain Trendelemburg position.
[0037] Observing the position of the two leverages 6 and 7, they pass from being inclined
toward patient's head (with upright backrest; Figure 5) to being inclined toward patient's
feet (with reclined backrest; Figure 6).
[0038] Suitably choosing the length of piston rods 6 and 7 and the leverages linked to them,
and modulating the angles of the four-bar linkage, different patient's positions and
dentist's ergonomics can be reached.
[0039] In particular, with respect to chair modularity, the basic version can be obtained
with the seat 3 components in use today, which are fixed to the turret 14, in its
turn hinged with the pantograph arm 5 through a simpler kit of leverages. Adding the
mechanism of the four-bar leverage comprising the two piston rods 6 and 7 with a different
kit of leverages, two results are obtained: Trendelemburg position with completely
reclined backrest, and longitudinal compensation movement. Adding a further leverage
12, the movement of the terminal part of the seat (leg-rest 13) with respect to the
fixed seat 3.
[0040] In this case, dynamically connecting through a transmission the leverage 12 for moving
the leg-rest 13, the leg-rest movement itself is synchronized to the movement of the
seat and of the backrest.
[0041] To the skilled person it is apparent that such movements can be performed through
a variety of different actuators: e.g. hydraulic, pneumatic, or electric actuators.
In the preferred embodiment, electromechanical actuators were used (endless screw,
direct current or alternating current motor).
- 1
- Dental chair
- 2
- Backrest
- 102
- Bracket
- 3
- Seat
- 4
- Chair base
- 5
- Pantograph arm
- 6
- Short piston rod
- 7
- Long piston rod
- 8
- First pivot pin of the short piston rod
- 9
- First pivot pin of the long piston rod
- 10
- Second pivot pin of the long piston rod
- 11
- Second pivot pin of the short piston rod
- 12
- Leverage for the hinging of leg-rest
- 13
- Mobile leg rest
- 14
- Turret
- 15
- Under seat
1. Patient chair (1) preferably for dentistry, comprising:
- A lifting group comprising a base (4) on which a pantograph arm (5) is hinged, which
is hinged on and shifts a turret (14),
- A moving group for relatively moving said seat (3), comprising an under seat (15)
which is in its turn hinged to said turret (14) through two piston rods (6 and 7),
wherein the reclining of the backrest (2) occurs according to an arc of a circle,
said chair (1) having moreover a longitudinal compensation mechanism,
characterized in that
said reclining and compensation movements are obtained thanks to the combination of
an arc prismatic guide system for backrest reclining, dynamically combined with a
four-bar linkage for moving the under seat (15) and seat (3), said four-bar linkage
comprising said two piston rods (6 and 7), said turret (14) and an under seat (15)
which links said seat (3) to said turret (14) and in that
- said movements are obtained through an actuator only and
- wherein the arc guide system comprises a supporting arc bracket (102) of the backrest
(2), said arc bracket slidingly engages with its end opposed to the backrest (2) in
an arc guide and stationary with respect to said under seat (15) mobile with respect
to said turret (14), said sliding of the arc bracket (102) causing a variation of
backrest tilting and a contextual translation of the said backrest (2) in the direction
of the chair longitudinal axis, and according to the angle of tilting and the direction
of tilting.
2. Patient chair (1) according to claim 1 or 2, wherein said actuator is chosen from
the group consisting of: hydraulic, pneumatic, electric or electromechanical actuators.
3. Patient chair (1) according to one or more of the preceding claims, wherein said seat
(3) is fixed and there is an articulation at patient's knee level with a leg-rest
(13) through a leverage (12).
4. Patient chair (1) according to one or more of the preceding claims, wherein said four-bar
linkage comprises two piston rods (6, 7) having different length.
5. Patient chair (1) according to claim 5, wherein the shortest piston rod (6) is positioned
towards patient's head, while the longest piston rod (7) is positioned towards patient's
feet.
6. Patient chair (1) according to one or more of the preceding claims, wherein said arc
prismatic guide allowing the hinging between backrest (2) and seat (3) is positioned
centrally, symmetrically with respect patient's longitudinal axis.
7. Patient chair (1) according to one of claims 1-6, wherein said arc prismatic guide
allowing the hinging between backrest (2) and seat (3) is positioned laterally, on
the right or left side with respect to patient's longitudinal axis.
8. Patient chair (1) according to one of claims 1-6, wherein there are two arc prismatic
guides allowing the hinging between backrest (2) and seat (3) positioned laterally,
on the right and left side with respect to patient's longitudinal axis.
9. Method for the respective moving of a backrest (2), seat (3) and optionally a leg-rest
(13), making use of at least an arc prismatic guide system and a four-bar linkage
consisting of two piston rods (6, 7) hinged on a fixed member which is the turret
(14) and a mobile member which is the under seat (15) connected with seat (3), having
as pivots pins (8, 9, 10, 11) on the piston rods (6 and 7), according to claims 1-9,
characterized in that it uses a supporting arc bracket (102) of the backrest (2), said arc bracket slidingly
engaging with its end opposed to the backrest (2) in an arc guide and stationary with
respect to said under seat (15) mobile with respect to said turret (14) and an actuator
only.