Dental Operating Microscopes

Dental Operating Microscopes

One of the most important developments in Endodontics in the last 20 years has been the introduction of the Dental/Surgical Operating Microscope. The use of the microscope may seem recent, but it has been utilised in the medical profession for over 50 years.

Endodontic therapy requires precision and great attention to detail. Most endodontic procedures are carried out in dark and confined areas of the tooth where fractions of millimetres may decide the outcome of treatment. Due to the intricate nature of endodontic treatment, practitioners have always sought to improve their vision of the operational field. Enhanced vision has had the benefit of improved clinical diagnosis.

The Dental Operating Microscope has uses for both Non-surgical and Surgical Endodontic Procedures. Some of the uses are highlighted below.

Non-Surgical Applications of the DOM:

For the endodontic practitioner, the dental microscope is useful for diagnosis and clinical procedures:

·       The microscope may aid diagnostically in identifying caries

·       Insufficient crown or restorative filling margins

·       Diagnosing cracked teeth (Figure. 1)

·       During root canal therapy, magnification and illumination provided by the operating microscope aids with caries removal

·       The removal of canal obstructions such as denticles, calcifications and fractured instruments. (Figure. 2)

·       Locating canals is one of the most important reasons: High magnification can help in the localization and instrumentation of obstructed and calcified canals and the identification of canal bifurcations. (Figure. 3)

Surgical Applications of the DOM:

Modern endodontic surgical procedures require a microscopic approach. Surgical endodontics has been completely transformed by microscopic procedures. The use of an operating microscope in endodontic surgery has necessitated the development of a specialised microsurgical armamentarium. Instruments have been miniaturised to an appropriate scale to enable the surgeon to utilise the enhanced vision that the microscope provides.

Many of the instruments used previously for conventional endodontic surgery are consequently not appropriate for endodontic microsurgery. For many years surgical burs and amalgam for root-end fillings were the standard of care. The incorporation of the microscope, together with the use of ultrasonic tips and biocompatible filling materials, has evolved the classical apicoectomy into modern endodontic microsurgery. All steps of endodontic microsurgery are carried out under varying degrees of magnification allowing a precise surgical procedure. 

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