Surgical operationg microscope

this presentation includes different parts of SOM, How it is mounted on the wall or the floor, its advanatges and disadvantages and how a dentist should maintain the microscope for better results.

1. 1
DR MEENAL ATHARKAR
MDS
DEPT OF ENDODONTICS AND
CONSERVATIVE DENTISTRY

2. CONTENTS
•Introduction
•History
•Optical principle
•Working of surgical microscope•Working of surgical microscope
•Parts of microscope
•Clinical applications
•Magnification ranges used for nonsurgical and
surgical endodontic procedures
•Advantages
•Disadvantages
2

3. CONTENTS
•Positioning of microscope
•Position statement of AAE on use of microscopes and
other magnification techniques
•Law of ergonomics
•Operatory design principle•Operatory design principle
•Misconception about surgical operating microscope
•How to care about the microscope.
•Conclusion
•References
3

4. INTRODUCTION
•With the development of clinical techniques that require high
levels of manual dexterity and fine details, there is increasing
interest in the use of magnification for dental procedures.
•Endodontic procedures were performed using tactile
sensation and only way to see inside root canal is radiographs.sensation and only way to see inside root canal is radiographs.
•Along with radiographs, various magnification systems-
loupes/telescopes have been used to perform conventional
endodontics.
4

5. •According to ZEISScompany, microscope was introduced to
endodonticsin early 1990s.
•Using Surgical microscope makes sense that if the clinician can
see something more clearly and magnified he or she can
better evaluate and treat.better evaluate and treat.
5

6. •Microscope also serves as a useful educational tool.
•The high magnification of microscope provides for a safer
procedure.
•Endodonticshave frequently boasted they can do much of
their work blinfoldedsimply because there is nothing to see.
•The truth of the matter is that there is a great deal to see if •The truth of the matter is that there is a great deal to see if
only we had the right tools.
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7. •The introduction of operating microscope has changed both
nonsurgical and surgical endodontics.
•The introduction of dental microscope and associated ability
to inspect the root canals-both orthogradeand retrograde
have fundamentally changed our understanding of dental have fundamentally changed our understanding of dental
morphology and its complexity.
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8. HISTORY
Dr. Apothekar, Dr. Jako Dental operating microscope-1981
(poorly configured,
ergonomically difficult to use,
Only 1 magnification-8x
Focal length too long-250 mm)
Chayes-Virginia (Evansville, IN)-
1
st
DOM. (Dentiscope)
8
Dr. Gary Carr-1992
Ergonomically configured operating
microscope
(galileanoptics)
1950
Otolaryngology
1960
Neurology

9. OPTICAL PRINCIPLE
•All clinicians must construct 3-dimensional structures in a
patient’s mouth 3dimensional perception.
•Attempts have been made to use the magnifying endoscopes
used in Artroscopicprocedures, but these devices require
viewing on a 2-dimensional (2D) monitor, and the limitations viewing on a 2-dimensional (2D) monitor, and the limitations
of working in 2D space are too restrictive to be useful.
9

10. •Several elements are important for consideration in improving
clinical visualization.
•Included are factors such as
•(1)Stereopsis
•(2)Magnification range •(2)Magnification range
•(3)Depth of field
•(4)Resolving power
•(5)Working distance
•(6)Spherical and chromatic distortion (i.e., aberration)
•(7)Eyestrain
10

11. (1)Stereopsis:
•Stereopsisvision where in two separate images from two eyes
are successfully combined in to one image in the brain.
•Also called as 3-dimensional perception.
(2)Magnification range:
•Magnification is ability to produce enlarged images of object.
•The Maximum magnification of human eye is .068 cm also
called as 1X magnification .
•So the image size can be increased by using lenses for
magnification.
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12. MAGNIFICATION RANGES
••
••
••
Low
(X3 to X8)
•wide field of
view and high
focal depth
Midrange
(X10 to X16)
•moderate focal
depth, keeps
the field in
High
(X20 to X30)
•focal depth is
shallow, the
field moves out
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view and high
focal depth
•orientation
within the
surgical field
depth, keeps
the field in
focus despite
small
movements
•“working
magnifications”
in endodontics
shallow, the
field moves out
of focus with
even slight
movements
•inspection for
fine detail

13. 13

14. (3)Depth of field : It is the range of a depth that a specimen is acceptable in
focus.
•Depth of Field is basically how much of the object under the microscope
can actually be viewed.
(4)Resolving power:
•The resolving power of a microscope determines the degree of details that •The resolving power of a microscope determines the degree of details that
is visible.
•The resolving power of normal human eye is 200 micron. Object separated
by less then this distance appears as single Object.
•Dentists can increase their resolving ability without using any
supplemental device by simply moving closer to the object of observation.
•Resolving power also enhanced by using the shorter wavelength Light for
illumination.
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15. (5)Working distance :
•The nearest point that the eye can accurately focus on exceeds
ideal working distance.
•Working distance of Microscope is inversely proportional to the
Magnification.
(6)Spherical and chromatic distortion (i.e., aberration) :
•Its type of Distortion in which there is failure of a lens to focus all
colorsto same point.
(7)Eyestrain:
•One might think that working constantly with the microscope will
cause eyestrain and eye fatigue.
•But what is true is just the opposite.
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16. Loupes
•Dental loupes have been the most common form of
magnification used in endodontics.
•Loupes are essentially two monocular microscopes with •Loupes are essentially two monocular microscopes with
lenses mounted side by side and angled inward (convergent
optics) to focus on an object.
•Magnifying telescopes sometimes are called "loupes."
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17. •Loupes are classified by the optical method in which they
produce magnification.
•There are three types of binocular magnifying loupes:
•(1) a diopter, flat-plane, single-lens loupe,
•(2) a surgical telescope with a Galilean system configuration •(2) a surgical telescope with a Galilean system configuration
(two lens system),
•(3) a surgical telescope with a Keplariansystem configuration
(prism roof design that folds the path of light).
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18. Single lens loupes
•It consists of simple
magnifying lens.
•The only advantage of
the dioptersystem is
that is the most
inexpensive system, but
it is also the less
desirable because the
plastic lenses that uses
are not always optically
correct.
Galilean lens loupes
•The Galilean system
provides a magnification
range from 2X up to 4.5X
and is a small, light and
very compact system.
Prism loupes
•Prism loupes are the
most optically advanced
type of loupe
magnification available
today.
•They use refractive
prisms and they are
actually telescopes with
complicated light paths,
which provide
magnifications up to 6x.
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correct.
•Furthermore, the
increased image size
depends on being closer
to the viewed object,
and this can compromise
posture and create
stresses and
abnormalities in the
musculoskeletal system.
magnifications up to 6x.
•Prism loupes also
provide larger fields of
view, wider depths of
field and longer working
distances than other
types of loupes.

19. 19

20. PARTS OF MICROSCOPE
•The main parts can be divided into 3 groups.
1.supporting
structure
2.the body of
microscope
20
structuremicroscope
3.
accessories

21. 21

22. 1. Supporting structure:
•Microscope must be stable while in operation.
•The supported structure can be mounted on the floor, ceiling
or wall.
•As distance between the fixation point and body is decreased,
stability increased.stability increased.
•In clinical settings with high ceilings or distant walls, floor
mount is preferable.
•The built in springs should be tightened according to the
weight of body of microscope.
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23. 23

24. 2. The body of microscope:
•Binoculars
•Eyepieces
•Magnification changers
•Objective lens
•Light source Illumination
Magnification
•Light source Illumination
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25. 2. The body of microscope:
•I. MAGNIFICATION is determined by :
•a) Eye pieces which are available in powers of
•6.3X, 10X, 12.5X, 16X, 20X.
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26. •It consist of
•1) A viewing side with rubber cup
•2) Adjustable dioptersetting (-5
to +5). to +5).
•3) Binoculars which is used to
hold eye piece which may be
straight, inclined or inclinable and
again of shorter or longer focal
length.
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27. 27

28. •b) Magnification changer:
•which may be a 3-5 step manual
changer or power zoom charger.
•c) Objective lenses :•c) Objective lenses :
•whose focal length (which ranges from
100 mm to 400 mm) determines the
operating distance between lens and
surgical field.
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29. •Most operating microscopes usually possess magnification
steps or increments that can be adjusted manually or with
motorized foot controls.
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30. The total magnification provided by the
microscope can be computed using the formula
•TM = (FLB/FLOL)×EP×MV
•TM –Total magnification
•FLB –Focal length of binocular •FLB –Focal length of binocular
•FLOL-Focal length of objectives lengths
•EP-Eyepiece power
•MV-Magnification value
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31. •The clinician should remember that most procedures are
made at minimum/medium magnification while maximum
magnification is used just to check what clinician is doing.
•By increasing magnification, illumination, depth of field, width
of operative field-decreased.of operative field-decreased.
•A typical microscope setup should have the following features
to be properly equipped for application in dentistry:
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32. •12.5 x eyepiece power
•125 mm inclined binoculars
•5 step changer ranging from 4x x 28x.
•200 mm objective lens
•Galilean optics focus at infinity and send parallel beams of •Galilean optics focus at infinity and send parallel beams of
light to each eye.
•With parallel light, the operator’s eyes at rest, as though
looking off into the distance, permitting performance of time
consuming procedures without inducing eye fatigue.
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33. •II. ILLUMINATION(light source) :
•Is mainly by means of a 100 watt Xenon halogen bulb, where
intensity is controlled by a rheostat and cooled by a fan.
•Illumination is mainly co-axial with line of sight, which means
that light is focussed between the eye pieces so that no
shadows will be visible.
•This is possible due to the usage of Galilean optics. •This is possible due to the usage of Galilean optics.
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34. •The light source is one of the most important features of
microscope, as it is responsible for illumination of deepest
portions of root canals.
•The light passes through a condensing lens, a series of prisms
and then through the objective lens to the surgical site.
•The intensity of light is controlled by a rheostat.
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35. •The traditional standard is still halogen(yellowish hue, peak
at 600-700 nm, ~3300K).
•the brightest option is xenon(like daylight, homogeneous
spectrum 400-700 nm, ~5500K), making it most useful for the
identification of fine details in deeper areas of the root canal identification of fine details in deeper areas of the root canal
system and documentation.
•Recently LED lights (green part of emission spectrum, low at
450 nm and 550 nm, ~5700K) became available and offer a
significantly longer lifetime, however, at a reduced brightness
compared to xenon.
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36. 3. Accessories:
•1) Pistol or bicycle grips
•2) Liquid crystal display (LCD) and high resolution monitors
which receives video signals from cameras.
•3) Integrated video camera
•4) Eye piece with rectilefield: used for aligning during video •4) Eye piece with rectilefield: used for aligning during video
taping and 35 mm photography.
•5) Auxiliary monocular or articulating binocular for dental
assistant.
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37. 37

38. •In order to deflect a certain percentage of light from the
eyepiece towards accessories, a beam splitter can be placed
between the binoculars and the magnification changer.
•The beam is generally split at a 50:50 ration (i.e. half of the
light is always available to the operator)light is always available to the operator)
•A photo or video adapter can be connected to the beam
splitter.
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39. HOW DOES THE SURGICAL
MICROSCOPE WORK?
•There has always been a doubt as to how, a microscope differs
from a loupe.
The dental microscopes uses the parallel beam path better
known as “the Telescope system” which follows galileanoptics
wherein focus is at infinity and parallel beams of light are send
39
wherein focus is at infinity and parallel beams of light are send
to each eye thereby reducing strain on clinicians eye.
illumination with operating microscope is co-
axial with line of sight.

40. From the light source light is reflected through condensing lens to an
array of prisms to the objective lens.
From the objective lens the light is
40
From the objective lens the light is
focused to the surgical field.
From the surgical site the light is reflected
back to the objective lens and then passes
through the magnification changers.

41. •
From magnification changers the light reaches the
binoculars wherein the beam is split and the surgical field
is seen through the eye piece.
41
The telescopic loupes follow the convergent beam
path that is the Greenoughsystem.

42. 42

43. CLINICAL APPLICATIONS
•I. In Conventional Endodontics:
•An operating microscope aids for better performance:
•1) visualizing root canal system in finer detailcleaningand
shaping more efficiently.
•2) It is important that the root canal system is dry before •2) It is important that the root canal system is dry before
obturationis done.
•It is only by examining the root canal with microscope that it
is possible to determine if canal is dried sufficiently.
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44. 44

45. •3) By means of adequate illumination and magnification
access is enhanced.
•4) In cases where root end closure is to be undertaken, it is
possible to view tissues beyond apex of root canal.
45

46. •5) Examination of root canal under magnification ensures that
air voids in canals are kept a minimum even for a base of
coronal access sealing.
•6) In cases of re treatment like post removal.
•7) Retrieval of broken instruments like file and reamers is •7) Retrieval of broken instruments like file and reamers is
possible.
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47. Modern Microscopic Endodontic Procedure
Sequence
1) The diagnosis indicates that endodontic treatment is needed and
tooth is anesthetized.
2) Following placement of the rubber dam, access is made. The
microscope is not needed for this step, although some clinicians
may prefer to use it.
3) Using the microscope at low to mid magnification, the pulp 3) Using the microscope at low to mid magnification, the pulp
chamber is thoroughly prepared for inspection.
4) Under high magnification (16x-24x), the floor of the chamber is
examined for additional canals
5) After the canal entrance is identified, the microscope is not
needed until a later stage. The apex is negotiated with a size 10 K
file and is then enlarged with size 15 or 20 files.
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48. 6) Gates –Glidden burs are used in
reverse order to enlarge the coronal
half or two thirds using the crown down
techniques
7) An apex locater is used to determine 7) An apex locater is used to determine
the canal length at this stage.
8) NiTirotary instruments now employed to prepare the
remaining one half or one third of the apical canal in the crown
down technique. The final apical preparation of the master
apical file is done by hand instruments and light Speed,
depending on the original canal width or estimate of working
width.
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49. 9) The microscope is used to check the
preparation and to check again for additional
canals.
10) A master guttaperchacone is selected,the
canal length and solid “tug back” is assured.
11) After obturationmicroscope is used again
for final check. Finally, the canal is filled with
temporary or permanent cements.
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50. •II. In Surgical Endodontics:
Magnification: at 3 different levels
•1) 2.5 X to 8 X for orientation of operating field.
•2) 10 X to 16 X -midrange magnification, are best for
performing root-end resections and root-end preparations.performing root-end resections and root-end preparations.
•3) 18 X to 30 X to observe and evaluate fine details –micro
fractures, isthmus etc.
50

51. •Illumination, which is simultaneous and focused, is an added
benefit to magnification.
•Micro instruments such as ultrasonic instruments aid in root
end preparation with greater accuracy and conservation of
root. root.
51

52. Conservative and Co-axial root end preparation
Identification of apex in intact buccalplate
Inspection of resectedroot surface
Bevel angle
RetropreparationRetropreparation
Retrofilling
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53. 53

54. •III. In Restorative dentistry:
•1) Removal of caries most conservatively.
•Since the tooth can be seen magnified it is easy to view the
extent of caries and thus there is no need to remove healthy
tooth structure blindly.
•2) Identification of crack lines, microgapsbetween the tooth •2) Identification of crack lines, microgapsbetween the tooth
and a filling becomes easier due to enlarged vision
54

55. •IV. In Dental Extractions:
•to determine if luxationforces applied using elevators result
in microscopic incremental improvements in tooth particle
luxation.
•perform dentoalveolarextractions with more conservative •perform dentoalveolarextractions with more conservative
removal of alveolar bone, potentially minimizing trauma to
the extraction site.
55

56. •V. In Periodontal Therapy:
•In periodontal procedures surgical
microscope can be used for,
•1) Diagnostic procedures
•2) Crown lengthening
•3) Regenerative periodontal •3) Regenerative periodontal
surgery
•4) Root coverage procedures
•5) Papilla reconstruction
•6) Smile designing and
•7) Implantology.
56

57. •VI. Use of fewer radiographs:
•For procedures like post space preparation etc, as its possible
to see at least till middle third with the magnification rather
than depend on radiograph.
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58. •
Ⅵ
. Patient education through its integrated video.
•
Ⅶ
. Documentation for dental legal purposes
•
Ⅷ
. Management of procedural errors
•
Ⅸ
. Best cosmetic outcome
•. Contrast•
Ⅹ
. Contrast
•
Ⅺ
. Ergonomics
58

59. 59

60. 60

61. 61

62. 62

63. MAGNIFICATION RANGES USED FOR
NONSURGICAL AND SURGICAL ENDODONTIC
PROCEDURES
63

64. ADVANTAGES
•1.increased visualization,
•2.improved Quality and precision of treatment,
•3.enhanced ergonomics,
•4.ease of proper digital documentation and
•5.increased communication ability through integrated video•5.increased communication ability through integrated video
64

65. •6.Better vision
•7.the microscope is a self-supported unit; therefore,
additional lenses or prisms are not a concern.
•8.microscope binoculars are arranged in a parallel
orientation. This arrangement is facilitated by prisms that let orientation. This arrangement is facilitated by prisms that let
the incoming light beams reach the eyes also in a parallel
direction.
65

66. •This simulates the observation of a distant object: a straight,
forward-looking gaze that causes less muscle stress and
fatigue.
•9.Orthograde and retrograde endodontics
•10.Periodontal therapy in visually barely accessible root •10.Periodontal therapy in visually barely accessible root
sections
•11.Precise control of prosthetic preparations and impressions
66

67. DISADVANTAGES
•1) It’s expensive.
•2) Its size which is difficult to fit in a small operatories.
•3) It takes the operator some time to get used to the
equipment.
•4) Need for expertise by auxiliary staff •4) Need for expertise by auxiliary staff
•5) Adaptation to indirect vision
•6) Narrower field
•7) Movement of the patient
67

68. •There are some disadvantages, especially at the initial stages,
most important one is the need for specific training:
•as a DOM has a restricted working field, 11mm -55mm .
•An operator using a DOM can see only the tip of the
instruments, and they are used in delicate movements of instruments, and they are used in delicate movements of
small amplitude.
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69. POSITIONING OF MICROSCOPE
•The introduction of the microscope in the dental office is a big
revolution that involves many ergonomic changes.
•To reduce as much as possible any stress for the operator, the
clinician should maintain the traditional working position
previously used without the microscope. previously used without the microscope.
•It is also important for the clinician to maintain good posture
with proper scope orientation.
69

70. •In chronological order, the microscope should be prepared
and positioned as follows:
•Positioning of the operator
•Positioning of the patient
•Positioning of the microscope •Positioning of the microscope
•Adjusting the interpupillarydistance
•Fine positioning of the patient.
•Parfocaling
•Fine focus
•Adjusting the assistant scope
70

71. •To position the operator, the microscope and the patient
correctly, the simplest rule to follow in nonsurgical
endodonticsis that
•the back of the operator should be straight;
•the light of the scope should be perpendicular to the floor and
also perpendicular to the root canal where he/she is working.
71

72. in nonsurgical endodontics( by
indirect vision); therefore the light of
the scope is directed to the mirror
and, from there, into the root canal.
In conclusion, the position of the
in nonsurgical endodontics( by
indirect vision); therefore the light of
the scope is directed to the mirror
and, from there, into the root canal.
In conclusion, the position of the
In surgical endodontics,( in direct vision),
everything is easier.
In surgical endodontics,( in direct vision),
everything is easier.
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In conclusion, the position of the
patient depends on the position of
the scope, and not vice versa.
In conclusion, the position of the
patient depends on the position of
the scope, and not vice versa.
everything is easier.
Nevertheless, in order to be able to check
the retroprepthrough a micro-mirror, the
light of the microscope should be
perpendicular to the axis of the root canal.
everything is easier.
Nevertheless, in order to be able to check
the retroprepthrough a micro-mirror, the
light of the microscope should be
perpendicular to the axis of the root canal.

73. Position Statement of AAE on Use of
Microscopes and Other Magnification
Techniques
•Position Statement of AAE on Use of Microscopes
and Other Magnification Techniques, published in
2012 recommends the following procedures in 2012 recommends the following procedures in
Endodonticscan be benefitted from the use of the
microscope:
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74. •
•
•
•
locating hidden canals that
have been obstructed by
calcifications and reduced
in size;
removing materials such as
solid obturationmaterials
(silver points and carrier-
based materials), posts or
separated instruments;
removing canal
obstructions
assisting in access
preparation to avoid
unnecessary destruction of
repairing biological and
locating cracks and
fractures that are neither
visible to the naked eye
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unnecessary destruction of
mineralized tissue,
repairing biological and
iatrogenic perforations
fractures that are neither
visible to the naked eye
nor palpable with an
endodontic explorer
facilitating all aspects of
endodontic surgery,
particularly in root-end
resection and placement
of retrofillingmaterial.

75. LAW OF ERGONOMICS
•An understanding of efficient workflow using an OM entails
knowledge of the basics of ergonomic motion. Ergonomic
motion is divided into 5 classes of motion:
Class I motion: moving only the fingers
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Class II motion: moving only the fingers and
wrists
Class III motion: movement originating from
the elbow
Class IV motion: movement originating from
the shoulder
Class V motion: movement that involves
twisting or bending at the waist

76. THE OPERATING MICROSCOPE: WHY IS IT
ESSENTIAL FOR MICROSURGERY?
•Microsurgeryis defined as a surgical procedure on
exceptionally small and complex structures with an operating
microscope.
•The microscope enables the surgeon to assess pathological
changes more precisely and to remove pathological lesions changes more precisely and to remove pathological lesions
with far greater precision, thus minimizing tissue damage
during the surgery.
76

77. •The operating microscope provides important benefits for
endodontic microsurgery in the following ways:
The surgical field can be inspected at high magnification so that small but important
anatomical details, e.g. the extra apex or lateral canals, can be identified and managed.
Furthermore, the integrity of the root can be examined with great precision for fractures,
perforations, or other signs of damage.
Removal of diseased tissues is precise and complete.
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Distinction between the bone and root tip can easily be made at high magnification,
especially with methyleneblue staining
At higher magnification the osteotomycan be made small (3-4 mm) and this results in
faster healing and less postoperative discomfort
Surgical techniques can be evaluated, e.g. whether the granulomatoustissue was
completely removed from the bone crypt.

78. The number of radiographs may be reduced or may be eliminated because the surgeon
can inspect the apex or apices directly and precisely.
Occupational and physical stress is reduced since using the microscope requires an erect
posture. More importantly, the clinical environment is less stressful when clinicians can
clearly see the operating field
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Communication with the referring dentists is improved significantly
Video recordings or digital camera recordings of procedures can be used effectively for
education of patients and students.

79. MISCONCEPTIONS ABOUT THE OPERATING
MICROSCOPE
•Experience suggests that magnification above 30x is of little
value in the periapicalsurgery because slightest movement by
patient, sometimes even breathing moves the field out of
view and out of focus.
•Surgeon must repeatedly recentreand refocus microscope, •Surgeon must repeatedly recentreand refocus microscope,
wasting valuable time.
•Thus, the belief that “greater the magnification the better” is
a misconception.
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80. •We do not believe that all surgical procedures have to be
performed at high magnification.
•For certain procedures, low magnification is better.
•Microscope does not improve access to the surgical field.
•If access is limited for traditional surgery, it will also be limited •If access is limited for traditional surgery, it will also be limited
when the microscope is placed between the surgeon and
surgical field.
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81. ARE SPECIAL INSTRUMENTS REQUIRED FOR
WORKING WITH MICROSCOPE?
•Working with microscope requires instruments designed to
keep fingers from getting in the way.
•Use hand spreaders instead of finger spreaders.
•Rotary files instead of hand files.
•Microsurgical instruments for apex resection.•Microsurgical instruments for apex resection.
•Use drills with longer shanks.
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82. POSTURAL PROBLEMS WITH
WORKING UNDER MICROSCOPE
MAGNIFICATION
•Restricted and posture dependent
access.
•Muscle tension and pain•Muscle tension and pain
•Assistant’s co-observation tube
moves.
82

83. Solution?
•MORA interface provides a solution by creating a
posture-friendly microscope system.
•The operator must be seated in 12 o clock position to
make following possible:
83

84. Swinging the microscope
body in panning motion to
right and left sides of
mouth, independent of
eyepieces.
Panning the microscope
body with ease due to
massive reduction in the
weight of moving parts
when compared to moving
the whole microscope.
Providing the assistant the
ability to sit in 3 o clock
position and utilize a co-
observation tube that can
stay level.
Allowing the operator to sit
in upright position with
upright neck and
eliminating the need to tilt
Allowing the operator to
equally extend the right
and left arms around the
patient’s head and thereby
Proper utilization of arm
and wrist supports
eliminating the need to tilt
the neck to the side.
patient’s head and thereby
work more comfortably.
and wrist supports
Giving the operator the
ability to stabilize and
control the patient’s head
movement
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85. CARING FOR THE OPERATING
MICROSCOPE
•Keep in a dry, cool and well-ventilated place to prevent fungus
growth on lenses.
•Every week, clean optics.
•To protect it from dust drape a cover over it.
•Wipe down the external surfaces with a damp cloth soaked in hot,
soapy water.soapy water.
•Cover the foot pedal with a clear plastic bag to prevent surgical and
cleaning fluids from entering and damaging the electronics.
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86. •Before using, test the controls of the foot pedal.
•Avoid kinking or bending the fiberoptic cables.
•When replacing bulbs, avoid touching them with your fingers.
•The oil left as fingerprints on bulbs can shorten its itslife.
•Do not move the microscope while bulb is still hot because •Do not move the microscope while bulb is still hot because
strong vibrations may damage the filament,
•Every six months, clean and oil the wheels and the brakes.
•Remove any surplus oil when done.
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87. THE FUTURE
•The next stage in microscopic endodonticswill involve the use
of even finer microscopic instruments and the development
of even more sophisticated techniques.
• Eventually, endodontistswill be able to re-vascularizethe pulp
and grow dentin. and grow dentin.
•These procedures will most certainly be microscopic in nature
and will be quickly embraced by a specialty already well
trained in microscopic procedures.
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88. •In the meantime, microscopic procedures are being adopted
by the other specialties in dentistry with impressive results.
•Restorative dentists and periodontistswill be the next
disciples to embrace a microscopic approach, and then it will
be only a matter of time before all of operative dentistry is be only a matter of time before all of operative dentistry is
performed microscopically
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89. CONCLUSION
•Endodonticshas changed tremendously in the past two
decades in relation to the use of equipments and instruments.
•This new approach of involving enhanced magnification has
rectified all the shortcomings of traditional approach, thus
making the procedure much more predictable and result making the procedure much more predictable and result
oriented.
•Those who perform endodontic procedures without the
microscope are still evaluating the benefits of its use.
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90. •After the initial learning curve, endodontic procedures can be
done in less time because of the greater visibility of the root
canal anatomy and procedural errors can be reduced.
•The key to successful endodontic practice lies in the operator
and his or her commitment. and his or her commitment.
•If sincere effort is made , one can be rejuvenated and
endodonticswill be more enjoyable.
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91. REFERENCES
•RahulKumar. Surgical Operating Microscopes in Endodontics: Enlarged
Vision and Possibility.
•Sharma N.MagnificationIn Endodontics
•Bertrand khayat. The use of magnification in endodontics: the operating
microscope.
•Prof. (Dr.) UtpalKumar. Recent Advances in Endodontic Visualization: A
Review Review
•Dr. Anil Dhingra. THE DENTAL OPERATING MICROSCOPE IN ENDODONTICS
•EudesGondim.DentalOperating Microscope in Endodontics-A Review
•Gary B. Carr .The Use of the Operating Microscope in Endodontics
•ArnaldoCastellucci. Magnification in endodontics: the use of the
operating microscope
•SyngcukKim.Microscopeand endodontics.
•SyngcukKim. Modern Endodontic Surgery Concepts and Practice: A
Review
•The Dental Operating Microscope in Endodontics
•The microscope in dentistry. An editorial forum for dental professionals.
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