Root canal treatment Root canal

Endo Surgery

retreatment

For what procedures is the microscope really essential?

Some enthusiasts claim that the microscope must be used for all steps of nonsurgical endodontic procedures

Root canal treatment 1- Diagnosis

The microscope is an excellent instrument to detect micro fractures that cannot be seen by the naked eye or by loupes, a persistently painful tooth after endodontic therapy may be due to an untreated missing canal (e.g., MB2 in a maxillary molar). Re-examination of the chamber at high magnification under the microscope may locate the missing canal.

2- Locating hidden canals

The canal anatomy is extremely complex. All endodontic textbooks have information on molar teeth with three canals, premolars with two canals, and anterior teeth with one canal. Often, dental anatomy is not that predictable There are teeth where the canal bifurcates at 3 to 5 mm into the canal and in the maxillary second molar, where the MB and DB are in very close proximity of each other; the microscope is an invaluable tool in clearly detecting the bifurcation and the two separate canals.

3- Management of calcified canals

When the calcified canal is looked at through the microscope at high magnification, however, the difference in the color and texture between the calcified canal and the remaining dentin can be easily seen.

4- Perforation repair
The microscope is the key instrument to identify and evaluate the damaged site. Briefly, the microscopic procedure is to place a matrix precisely, after the matrix is placed, mineral trioxide aggregate is packed against the matrix. This procedure requires delicate and careful handling of the materials so as not to extrude, overfill, or under fill. The microscope is essential for this procedure.

5- Final examination of the canal preparation

It takes a simple step to see whether a canal is completely cleaned. Under the microscope, a small amount of sodium hypochlorite, a popular irrigation solution, is deposited into the canal and observed carefully at high magnification. If there are bubbles coming from the prepared canal, then there is still remnant pulp tissue in the canal. In short, the canal needs more cleaning.

Root canal retreatment

*Using microscope in retreatment enhance The outcome of the retreatment such as: 1- Could detect missed canal from previous RCT 2- Powerful tool in open apex 3- Separated instrument from previous RCT could be easily managed

Any challenge existing on the straight portion of the root canal system, even if located in the most apical part, can be easily seen and solved under Microscope

The operating microscope in surgical endodontics

Surgical endodontic is the specialty that has benefited the most from a microsurgical approach. The introduction in 1990 by Excellence in Endodontic (EIE) of a dedicated microsurgical armamentarium has revolutionized surgical technique and vastly improved the skill level of an entire specialty. The incision is made with a microsurgical scalpel blade and, therefore, is more precise, repositioning of the flap is also more precise and later there will be no scar. The introduction of optical-grade micro mirrors has facilitated the detailed examination of the beveled root-end in apicoectomy procedures. The orifices of lateral canals can be identified, prepared and sealed, in order to obtain a three-dimensional obturation of the root canal system even with a surgical approach. Ultrasonic root-end preparation has revolutionized apical surgical procedures, reducing the need for exaggerated bevels and by reducing osseous crypt size. Recent studies show that surgical endodontic procedures performed under the operating microscope are followed by a success rate of 96.8%, with an average healing rate of 7.2 months

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