Microscope Enhanced Dentistry is just starting to become available in India.

It will soon
become a standard feature in advanced dental clinics in the future here in India as well
as around the world.Microscope Enhanced Dentistry is a new service which is spreading
across the globe, slowly but surely.
Teeth are normally small structures like the eyes, ear nose. E!T surgeons,
ophthalmic surgeons neurosurgeons nowadays routinely use an operating microscope
or magnifying loupes"spectacles to do surgeries of greater precision and accuracy.
#ataract surgery is nowadays routinely done with a microscope nowadays.
It is a stunning treat to watch teeth which are only $ s%.cm in si&e magnified to fill a T'
screen $( or )$ inches cross** +nd the joy of seeing a smile is all the more gorgeous to
watch on a large T' screen. + big smile is made much bigger by the magnification
provided by the microscope. +nd the highly improved %uality of the fillings, ,#T-s,
crown and bridge preparations and various other procedures which can be done with
the microscope make the patient smile even more* The patient-s confidence in his
dentist is hugely increased as he can see the problems in his teeth very clearly under
brilliant light and magnification. They co.operate better during the treatment as they
are able to see on a T' screen the whole procedure being undertaken on their teeth,
and it also ensures better compliance with advice given.
The dentist who uses the microscope is much more comfortable and avoids un.due
strain on his neck and back. The up.right posture can be maintained during almost all
procedures, which is otherwise impossible. /ccupational stress and strain on these )
areas are very high and there are some incidences in the 01+ where some senior and
e2perienced dentists have only been able to continue working after starting to use the
microscope, thus enabling more patients to continue to benefit from their huge
e2perience. The microscope can be used to magnify almost all the procedures which are
done routinely by dentists. 1ince the eyes are not seeing the work area directly as
before, a lot of training has to be under.taken to master the use of this new device
effectively
The use of the same operating microscope in the field of dentistry has just started
recently in 3estern Europe and parts of +merica. The +merican Dental +ssociation has
made it mandatory and compulsory for higher post.graduate training in endo.dontics or
the root canal treatment speciality to be trained in the use of the operating microscope.
It is estimated that 456 of the endodontists in the 01+ now own or use a microscope
at least part of the time. + select few dental colleges have started to introduce
microscopes at under.graduate level. 7ut many general dentists and other dental sub.
specialists like periodontists, oral surgeons and prosthodontists have also pioneered
and mastered the use of the microscope in their practices. This is a revolution in the
dental world 8 the amount of improvement of care in dentistry done under
magnification with the use of the microscope is very very high.
1ince microscopes have been used for endodontic ,#T-s , e2tra canals called M7)-s and
other minute accessory canals have been found and treated effectively which were not
possible before. Thus, the chances of failure of ,#T becomes much smaller. Doing
complicated procedures like failed ,#T and removal of broken files deep inside the roots
of teeth are challenges which demand the use of a microscope. Teeth will failed ,#T-s
can be re.treated with a second ,#T and successfully saved, when done very carefully,
and the chances of success are much higher when done under the microscope.
1ome teeth have decay which almost re%uire a ,#T if done with the naked eye. 7ut
with a microscope and a special caries detector dye, only the decay can be removed
and a ,#T avoided. !o normal tissue is removed because it is possible to see the
difference much better and clearer under magnification.
1caling or cleaning of the teeth done under the microscope affords better removal of
tartar and stains and cleaner teeth at the end. 9eriodontal flap surgery when done
under the microscope, is able to remove much more damaged tissue, with much less
damage to nearby healthy tissue, and hence give a better result. 1uturing of wounds
done under the microscope is much finer and delicate, hence better scars, faster
healing, less post.operative pain discomfort is possible.
9reparation of teeth to fit a metal or ceramic artificial crown is a routine procedure done
in every dental clinic routinely. If a microscope is used for this while preparing the
tooth, the margins of the teeth are much more neater and precise, thus allowing a
much better fit of the artificial crown, better esthetics and longer life with less problems
like leakage and failure. The crown can also be checked before fitting on to the tooth
under the microscope to check for defects in shape, si&e and irregularities as well. :ess
tooth structure is removed as well if possible, because we can see more clearly.
The fitting of crowns and bridges is made very precise and hence the longevity of these
is hugely increased.
Modern surgical practice in most areas of surgery are aimed to deliver a smaller
incision, smaller scar, reduced pain, faster mobili&ation and a much better %uality of
outcome. To achieve this, advances like laparoscopy in general surgery, arthroscopy in
orthopaedic surgery, endoscopy in urology have all played their part. 1imilarly, the use
of the microscope in neurosurgery, ophthalmic surgery, plastic surgery etc is also
helping in giving such benefits to the patient nowadays. The operating microscope is
used in so many areas of surgery and medicine nowadays, it has almost become
mandatory. The twin benefits of fantastic shadowless illumination and higher
magnification make it un.beatable.
+t a meeting held recently in #oimbatore on Microscope Enhanced Dentistry, a well
known plastic and microsurgical reconstructive hand surgeon remarked, ;<ou can only
treat what you can see well. <ou have to use the microscope to know how good and
useful it is.=
Sun
9
Dec
Microscope assisted precision dentistry
articulatingmicroscope
This article is about the use of microscope assisted precision dentistry, or the use of microscope
in oral health treatment. Although microscopes have been used in medicine as early as 1921, it
wasnt until the early nineties that microscopes were to be used for dental applications. Shanelec,
Tibbets, !eldman "uddle, !riedman and others were able to publish a series of papers that
documented the use of microscope n endodontics, termed #microscope assisted precision
dentistry $%A& dentistry'. And in 199( the American Association of )ndodontics $AA)'
proposed all postgraduate students should have an e*perience in operating and handling of a
microscope, in order to +ualify for a license in endodontics. ,n Australia where advancement is
pioneered, dental laboratories have been using microscopes as early as fifteen years ago for
chec-ing filling margins and castings. Some ma*illofacial surgeons and other dentist have used
microscopes for apicectomies. .ith %A& dentistry, it is now possible to remove decayed dental
tissue $caries' to its interface without affecting the normal ad/acent tissue. The +uality and
precision that %A& dentistry has brought raised the accuracy in removing decayed tissue without
unnecessarily sacrificing normal intact dentin. .ith this success it prevents the occurrence of
secondary caries.
Dr. &eter 0otschy is a strong advocate of preventive, periodontology as well as minimal invasive
dentistry, as such he has been using microscopes for preventive operations, periodontal and
restorative procedures, endodontic, and prosthodotic wor-, enabling for a precise removal of
secondary caries which was difficult before microscopes were introduced. .hat are the
advantages of a microscope, first we have to loo- at the disadvantages. 1onventionally, a
decaying tooth is treated and filled with amalgam. This procedure is without certainty and
complete caries control cannot be assured. ,t is a fact that a 1223 caries control is impossible
and a secondary caries will li-ely occur. ,n a secondary caries, it is actually a residual of primary
caries, this are caries which were not completely removed. Although in the field of amalgam
filling advancements have been made on the improvement of the type of amalgam filling, a
tightly sealed amalgam cannot assure a secondary caries will not develop. Thus the article states,
if we were able to completely remove primary caries will then be able to prevent further residual
decay from spreading.
%icroscope assisted precision dentistry $%A& dentistry', is one of the field in medicine were an
articulating microscope is needed. 1onsidering that dentistry as the article states, is one of the
medical specialty with the most demanding precision standards. %icroscopes have evolved from
fi*ed type to articulating microscope types. Articulating microscope has the advantage of
mobility. .ith an articulating arm, the articulating microscope can shift from one position
without moving the entire e+uipment. 4i-e most microscope in the field of surgery, articulating
microscopes have video attachment capability wherein videos or images can be seen from an
e*ternal monitor. The use of microscope assisted precision dentistry $%A& dentistry' is not only
challenging but also time consuming, but considering the brea-through in oral health surgery5 in
caries control, Dr. &eter 0otschy recommends the use for endodontic treatment and all other
dental wor- in the fight to control caries. Article lin-

BLOG

ITS ALL IN THE DETAILS-MICROSCOPE DENTISTRY
DR. GLENN A. VAN AS
HOW YOU VIEW THE PROFESSION
THE D.O.M. AND POST CORONAL SEAL
MONDAY, DECEMBER 3, 2007
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UNCOVERING MORE ANATOMY
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TROUGHING FOR E?TRA PORTALS OF ENTRY -POE2- A LONG REVIEW.
SATURDAY, DECEMBER :, 2007
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ACCESS WITH THE OPERATING MICROSCOPE- THE ELUSIVE MB2
THURSDAY, NOVEMBER 2A, 2007
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ENDO AND THE OPERATING MICROSCOPE - PART 2
TUESDAY, NOVEMBER 27, 2007
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ENDO AND THE OPERATING MICROSCOPE - SHOW ME THE LITB
MONDAY, NOVEMBER 2<, 2007
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PAIR OF CRACCS - A PREDICTOR OF INTERPRO?IMAL DECAY
SATURDAY, NOVEMBER 2=, 2007
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LOOC WHAT I FOUNDB
THURSDAY, NOVEMBER 22, 2007
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USING THE FULL RANGE OF MAGNIFICATIONS
WEDNESDAY, NOVEMBER 2:, 2007
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OLD EYES, YOUNG EYES, ANY EYES.
TUESDAY, NOVEMBER 20, 2007
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0*"#. At the end of 30 days, the results showed that all positive control teeth
leaked within 1 week, whereas those that served as negative control remained
uncontaminated throughout the test period. With both organisms, I! started to
leak after 10 days, whereas "avit and #yract leaked after $ weeks.
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all materials e*cept between #yract and %etric. %his suggests that it may be more
prudent to use a permanent restorative material for provisional restorations to
prevent inade+uate canal sealing and the resulting risk of fluid penetration.
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ACCESS AND THE OPERATING MICROSCOPE
UNCOVERING MORE ANATOMY
SATURDAY, DECEMBER :, 2007
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TROUGHING FOR E?TRA PORTALS OF ENTRY -POE2- A LONG REVIEW.
FRIDAY, NOVEMBER 30, 2007
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