1. Introduction to Mobile Dental Clinics
Crafter Mobile Dental Clinics: The method described improved the availability and number of mobile dental clinics for the Arad-Timis-Caras Severin Taskforce. The Mercedes-Benz Sprinter was not obsolete, and the savings were significant. Authorities should encourage the use of this method.
Methodology: There are three components necessary for mobile dental clinics: a building, a dentistry outfit, and a transport method. We built 16 mobile dental clinics from the Mercedes-Benz Sprinter manufacturer in Romania under license.
The purpose of this paper is to describe experiences in Romania using case study methodology to produce mobile dental clinics through remediation of the Mercedes-Benz Sprinter from the Volkswagen Crafter manufacturer, in an effort to address the progressive scarcity of mobile dental clinics for rural children populating the Arad-Timis-Caras Severin counties.
1.1. Definition and Purpose
The converted car allows you to maintain operational indicators in the working compartments. There is everything for compliance with the conditions at a high level. There is a supply of technical refrigerators for transporting drugs, facilities for washing and taking sterilized medical instruments and, of course, everything necessary for the comfort of a professional. The complex includes furniture manufactured with vacuum processing technology. They allow you to plan the space in such a way that the work cannot be interrupted by the movement inside the transportation compartment.
This project is about manufacturing mobile dental clinics using Volkswagen Crafter assembly and creating a comfortable working area. In the course of implementation, the transport is converted into specialized premises, properly designed and finished. It is necessary to say that professionals work best where they are most comfortable. And this is understandable – working in normal conditions, they carry out tasks accurately and correctly. Such cars are a mobile solution that allows you to create comfortable conditions in your area of activity, managed by skilled craftsmen.
1.2. Benefits and Challenges
Certainly, the creation of necessary equipment as well as an expensive vehicle requires government subsidies (or at least low-interest rate credits) without an unreasonable increase in the federal deficit. At the same time, for example, in large North America, acupuncture (hundreds of thousand offers of services at any time of day or night) is paid by private patients often even using friendly barter service, and in Germany, a small country with an open market economy, a 5-year waiting list is observed for state patients with a cough. Data on concrete needs in dental service for different layers of the population let us know if these services will be useful for proper places or they will require a new bottleneck of experts.
The benefits of the project of creating mobile dental clinics on the base of the vehicle are, first of all, benefits for the people living in remote regions far from cities and big towns. Going by private as well as paid for by municipal or regional authorities as it is probable for Russia, dental service of such places will be much less expensive than private car clinics which are used by dentists when a driver accompanies an office manager or supervisor. Besides, working days and working hours of mobile dental clinics are more than the stationary clinics in depressing rural settlements. So, the paid for municipal health service of an extremely exhausted patient is much cheaper than a free federal hospital nursery offering pediatric dental service only 3-4 hours per week if they are lucky.
2. Volkswagen Crafter as a Platform for Mobile Dental Clinics
Volkswagen Crafter, in comparison with analogues, has great advantages in terms of the width between wheel arches, it is also the lightest van in its class. The body can be 590x2x50mm high, 3x2x50mm wide and 4100mm long. A rear drive, a narrow power elements niche, compact power plants, as well as excellent cross-country ability, contribute to the choice of the Volkswagen Crafter as a platform for the creation of mobile dental clinics based on it. The volume of the luggage compartment of a Volkswagen Crafter with a 3.4m body is 11.6 cubic meters. As a result, inside such cars, you can place two dental modules of the “SanMiDent” type, each of which contains its own autonomous dental complex with water and electricity supply. With the need for such vehicles, their capacity can be doubled by installing 1.7 cubic meters additional boxes mounted on the roof. The equipment package includes water tanks, 12V, 220V electrical systems, LED light sources, generators, and an autonomous water heater.
The conversion of motor cars into ambulances or mobile intensive care units using available products of world-renowned automotive manufacturers as platforms is an international practice. In this article, we would like to demonstrate the possibility of turning new Volkswagen Crafter minivans into modern mobile dental clinics. The main obvious advantages of this solution will be the availability of warranty service within the state guarantee. In addition, recently, specialized service centers that can perform warranty and post-warranty service for any modification of these cars have been opened in the regions of Sverdlovsk and Chelyabinsk oblasts.
2.1. Overview of Volkswagen Crafter
The unit consists of a mobile clinic that is capable of attending to children in a comfortable and constrained way. The mobile dental clinic was developed with electronic engineering concepts in addition to control and systems modeling. It was planned to be mounted in a 2015 Volkswagen Crafter and only occupies 2 of its 4.8 m. This way, the manager can already purchase the unit ready or adapt some of the most existing similar models, such as Mercedes models and Volkswagen management. Thus, professionals with a knack for assembly can choose to mount the automation according to regulatory output; infrastructure drawings can be used as a basis for some possible adaptations, different environments as well as in other utilities. The main features of the developed mobile dental clinic are: develop it to assist children in rural and urban areas, use rear parks of schools, have five dental chairs, use a central suction system and therefore not require sewage. It has a lateral pressurized water inlet for treatment and handwashing. A waiting room, large auxiliary room, and two rest and street shower rooms on the staff side.
In our previous work, we developed a mobile dental clinic and mounted it on a Peugeot Boxer van. In the development of a portable dental clinic aboard an Iveco Daily van is presented. In, we presented the feasibility study for the establishment of a dental clinic to serve schools on board a Land Rover Defender. The disadvantage observed in these cases is the difficulty in fast and low-cost scaling for service across the country. It is observed that the time to develop these cases is so long that replication costs (considering only labor hours) are extremely high. From here, this work seeks to develop a fast, low-cost mobile dental clinic with the automation and design codes of Volkswagen Crafter. The research behind this study was motivated by Brazil’s move to establish initiatives to promote dental care in school environments, such as the Oral Health in Primary Care Program of the Department of Primary Health Care (2003). In this context, we developed a Mobile Dental Clinic for school environments.
2.2. Key Features for Mobile Clinic Conversion
The Volkswagen Crafter commercial van, having the mentioned basic requirements for a mobile dental clinic, is an appropriate vehicle for a mobile dental clinic. The dimensions of the vehicle used by us and its selected customized internal space usage are depicted in Fig. 1, wherever adequately necessary. The detailed engineering plan is discussed in previous works. The cost of the mobile clinic economic figures has a critical direct opportunity cost element, in terms of excess unused vehicle proximity loss. With this vehicle, it helps in reaching out to more remote areas. The clinic is designed in such a way that there are separate dentist space and individual dental treatment stations that are compliant with the present fitness Indian standards document, published by the Bureau of Indian Standards. The cost of the approximate van for dental treatment, mobile dental operator, and the cost for specialized coach sections are depicted in Table 1.
The commercially available mobile vans can be converted into mobile clinics by use of custom-made cabinets. In India, many organizations such as HOPE worldwide and Panacea Medical have done this exercise. Some unique features of these mobile vans are that they have a separate space for the dentist operator, allowing necessary workspace as well as storage of equipment and accessories separately. They should also have a working space for the doctor and assistant, space for storing clean and soiled instruments manually, cabinets for consumables and stationary, and space for an ultrasonic scaler, x-ray viewer, etc. The clinics should have good ventilation, a hydraulic-powered dental chair suitable for wheelchair-bound patients, and a bulkhead with double doors and a glass window with mosquito mesh. The mobile dental vehicles assist the dentist in providing comprehensive dental care.
3. Designing and Customizing the Crafter Mobile Dental Clinics
The mobile dental clinic, or better understood as the mobile dental unit, is designed and fitted into the Volkswagen Crafter, a vehicle which has a high level of versatility, specification, and reliability, giving the clinic a 4-star crash safety performance. A rearview camera was installed, adding ease and safety to driving in low-income communities. The Volkswagen Crafter has a large frame structure and a long outward body, unveiling spaces for each dental unit. All gear is in the same area, with spaces for pile formation and easy access inside the vehicle. The access into the vehicle was also designed in such a way that it was designed to break it evenly into flat surfaces, providing an area where flat access to the vehicle can be assimilated, and the other side fortifying a joint platform corner, preventing tripping hazards for the general public. The set of equipment purchased can be found in Supporting Information Protocol S1.
The mobile dental clinic was specifically designed, constructed, and commissioned by CMH, using domestic services and materials, and took just three months to complete. However, the mobile dental clinic was designed simplistically, with each detail based on accessibility, intended use, space-saving, functionality, ergonomics, and durability. Dimensions were taken into account with respect to functionality for an average height and size person of African origin. The vehicle was also designed for portability, to be able to be driven and stowed away in small townships with poor infrastructure, such as gravel roads, and maneuver easily. Additionally, the design and installation of each niche is determined by CAD drawings, ensuring an effective and professional-looking clinic. Every niche was also built with the capability of adding or removing modular components, as demanded by specific dental services, without affecting the structural integrity of the vehicle. Schematics of all dental services, compartment layout, measurement details, and equipment lists are detailed in Supporting Information Protocol S1.
3.1. Layout and Interior Design Crafter Mobile Dental Clinics
In addition, the organization of medical care at home and in the field, in remote areas where access to the above-mentioned medical facilities is not sufficient, leads to the development of mobile medical units. It is a complex vehicle structure suitable for patient care, family emergency care, rehabilitation, telemedicine, and medical education. The mobile dental unit is a vehicle equipped for dental services in places where the standard dental office is not available and is normally associated with medical care in the home. Different transportable structures have been developed that adapt the equipment and facilities of a dental clinic for the home environment, improving the dental ergonomics process. It is considered that no study has yet addressed the different aspects to consider in the design of the dental office, considering the specific needs, regulations, and technical characteristics of dental equipment. The design of the trailer structure with the necessary infrastructure takes place within the framework of an FCT project established between Civil Engineering and Mechanical Engineering.
In current days, such important issues like mobile dental clinics receive little attention from scientists. This important issue requires urgent attention and a radical solution. Taking into account the existing technical means and the experience of the profile departments, the task is to create a compact mobile clinic that is most adapted to the conditions of work, based on specific clinical tasks and working with the patient. The purpose of the vehicle is to carry out different types of medical diagnostics and therapeutic practices. The vehicle should be equipped with all the necessary technological equipment, auxiliary systems, and systems supporting vital functions such as lighting, air conditioning, and heating, to provide comfortable conditions for the work of the medical and paramedical staff. Depending on the vehicle, the necessary set of equipment and tools, and the scope of services, the trailer should be equipped with the necessary infrastructure: wiring devices, a system of water and sewerage, heating, ventilation, and air conditioning.
3.2. Equipment and Technology Integration Crafter Mobile Dental Clinics
The X-ray diagnostic and therapeutic module is equipped with a Konex Dental mobile dental X-ray, which allows you to convert a hospital department into a fully functional radiological exam room. This module also houses an ART-Park dental laboratory workbench for making dental crowns. A module with a sterilization unit is provided on the right side, in which a Zeta-8-3 sterilizer, an ultrasonic water disinfection system, and a Mira-Kontrol water quality control system are installed. Dental supplies were installed in the working cabinets. The cabin is equipped with a standard furniture group of a universal suit, a stock cabinet, and a modular assembling cabinet. All working cabinets are designed to provide staff with personal and collective protection, as well as to organize work surfaces with sinks, cabinets and shelves for storing and handling dental, engineering, medical tools, and accessories.
This integration is aimed at improving the quality of service and reducing the treatment time for dental patients who are unable to visit stationary dental clinics for various reasons. The use of modern technology contributes to a significant increase in the effect of preventive work, the development of therapeutic and surgical dentistry. Standard dental equipment was installed along the body. To install dental units, an internal space with a height of 2.7 m, a length of 3.95 m and a width of 2.2 m is provided. At the entrance to the clinic, a chair for patients and working places for the dentist and the nurse are mounted. Dental units are positioned along the walls along the right and left sides along the body.
4. Manufacturing Process of Crafter Mobile Dental Clinics
A solution was found, and the working height was, even with the split-off of the main part of the section, maintained at the same place where it was with the original partition, which provides space for all necessary dental accessories.
The condition for the design and the installation was that both the upper and lower parts were to be protected from severe mechanical damages. Therefore, a compromise solution with the larger impact absorbing forces of several components inside this modular unit was installed. Each of these main office sections was made vertically folded in places where necessary and consists of a special vertical adjustment of the swivel chair, which in this implementation includes the possibility of duplicating the number of functions in the dental units.
The main idea and the goal of the initial plan were to join several individual offices in one person modular unit, which resulted in the perfect bending of the routes for air conditioning, possibility of encrustation of the windows, and their suitability.
Striving to optimize the use of all available resources and in order to achieve the flexibility of the proposed solutions, the team used the method of paneling the Volkswagen Crafter van interior spaces except for the dashboard and front cab. The five-seats version of Volkswagen Crafter van is divided into four main sections separated with the factory partition. To get maximum use, the original partition was moved forward for 580 mm. Then the door was closed and the new partition was profiled in aluminum profiles with the necessary light mounted system, forming two main office sections. Free interior space evacuation must be done without effort on both sides, which represents an exit that will only be used in case of need (extreme situations).
4.1. Conversion Process Overview Crafter Mobile Dental Clinics
The 3D model (e.g., .CAD file) designed accurately details each component of an MMC; it includes overall and specific MMC architecture that consists of an ergonomic seating system, all the necessary requirements for the correct performance of professional responsibilities, specifically organized dental devices and surrounding decoration equipment, clearly defined workplace, and strong management of the dental workflow. The used 3D model allows to create any virtual views of an MMC either at the design phase or in all subsequent stages of the MMC production, i.e., to generate blueprints from different angles and details, annotate components, and set specific hierarchical relationships among subassemblies, assemblies, and the entire structure of an MMC. As a result, a correct and full manufacturing specification necessary for each stage of MMC conversion and its delivered results are obtained.
In the MMC conversion process, several stages and subcontractors are involved: the base van is received in working and initial condition; some technical, construction, and visual modifications are performed if necessary; additional materials and minor assemblies are established; design works applicable for required equipment and their locations are prepared; and the internal part of an MMC is set to the manufacturing stage, enabling the prepared material and equipment to be installed. After all the indicated works are done, the testing of newly created MMC is staged, and as an outcome, the whole MMC ready to work is delivered to a customer.
In essence, an MMC conversion is a process that takes a standard van as a base platform, adds various dental equipment and materials necessary for a clinic to be fully functional, and installs a range of equipment, materials, installations, and decorations for sitting therein of patients and medical personnel to ensure dental services given or received by specific requirements. A number of OEMs and private companies engage in such conversions.
4.2. Quality Control and Regulations Crafter Mobile Dental Clinics
After the initial planning for the production is completed, it is important to outline all necessary steps that will be executed in the next stages of the process. In the works manufacturing mobile dental clinics, the general quality control process result is the high quality and the reliability of the complete product according to the requisite dynamic and static loads necessary to mount mobile dental installations, with optimal crew working conditions. At the same time, the complete production process includes many operations, forms, and installations that should meet all standards in order to guarantee the high degree of compliance and efficiency. From the very beginning, when the junction between the driving cabin and the rear of the van is achieved, the execution of the process with high quality is mandatory, especially where there is a need to chase and make new alterations on the crates. These processes have as their main objective the high quality of the entire door-join work of the cabin with the rear of the van. The engineering department of the Van Engineering Company was responsible for all project development until the 3D models were completed and the van structure engineering was calculated.
The design and manufacturing of new and completely unique products, such as the production of mobile dental clinics, require high control of processes and results. The quality control process of the manufacturing of a mobile dental clinic includes various measures and actions at each stage of the process. The goal of the quality control process is to ensure that each one of the manufacturing stages in the different production areas meets the general requirements and specific standards for the manufacturing of the mobile clinic. The important aspects of the quality control process for the manufacturing of the mobile dental clinic are ensuring the implementation of all regulations and standards for the respective industry and technologies, the meeting of all structural and installation requisites, and the superintendency of each particular stage and the process as a whole. This guarantees the high quality of the final product – the contemporary mobile dental clinics mounted on Volkswagen Crafter van.
5. Case Studies and Success Stories
In the years of company’s operation, we realized that the re-equipment of existing cars into mobile medical complexes is rather difficult, resulting in high risks of vital systems trespassing, as well as in the possibility of the necessity to purchase new equipment meeting dozens of standards. The procedures for custom clearance and prescription of expertises may cost more than the purchase of the first medical equipment. German car manufacturer Volkswagen took into account specifics of our clients and offered an assembly line of mobile dental clinics, which are installed using original special modules, as a part of the car “Krafter” diagram. We will tell you in further details, however, those who would like to learn some details or collective conditions as soon as possible can write a request through the contact forms or a call to our headquarters at the office. All our clients are located in 30 regions of our country and the neighboring states, and more than 8000 medical institutions are clients of our company.
5.1. Real-world Applications
In many factories, vans already embed some WSM skills including mounting cabinets, floors, and some basic furniture. The VW Crafter, as well as some other brands, are one of them, supporting all the structural assembly of an ambulance or dental clinic at the factory, minimizing costs and granting warranties. The demand for traveling mobile dental clinics is widespread in many communities around the world, ranging from small towns to large cities, and even differs within towns, where, for example, North Dublin is one of such cases. Filipe and Silva report so, noting that possible complementary revenues and better personal working and leisure time also exist. Some Portuguese city councils and agrarian parishes already use WSM skills upon commercially acquired trailers that accommodate the VWMDC.
Here, we look at a real-world application that asks for the development of a VW Mobile Dental Clinic (VWMDC) based on Volkswagen (VW) Crafter. We present an overview of manufacturing the VWMDC. Design and manufacturing have historical ties to WSM. Some examples are shovels, which are found in many metallurgical plants, old hand tools for agricultural activities, which may be found in some hospital pharmacy WSM areas (restored), and prostheses such as paints for patient transfer in bed and the simple and cheap Snagle Foot found in many Brazilian WSM areas.
5.2. Customer Testimonials
The developed and modified project of using the Volkswagen Crafter for installing a mobile dental clinic will be partially used for the scientific and technical enterprise “Master” for demonstration examinations. The developed and developed project has proven to be beneficial and necessary in addressing medical care issues by providing mobile healthcare workers in order to reduce exacerbations of individuals in need. The mobile dental clinic will be equipped according to the approved plan, and, based on the current time and cost-effectiveness, the advantages of having medical injections in remote localities without travel, namely for the services of surgical dentistry, orthopedic dental care, and therapeutic dentistry will be provided. The consumer examines section 3, in which the developed project is represented in the form of photographs that are supplemented by a drawing with the designation of a modified Volkswagen Crafter purchased for the enterprise.
The technique for producing mobile dental clinics using the Volkswagen Crafter and the required equipment set in them allows you to quickly and efficiently reach the target audience who need emergency dental services or a complete examination, possibly traveling or at a mining enterprise, which reduces the travel time of specialized personnel. At the same time, the prices for mobile dental clinics can differ significantly from those indicated by us consumers, so it is better to clarify this information in a short conversation with customers from regions close to us. In general, when creating or purchasing a new mobile dental clinic using the Volkswagen Crafter, an individual approach for each customer is a qualitative and reliable solution. This is the final qualifying work of having practical prospective orientation in the future.
