Dentistry is a rapidly growing branch of medicine. The last three decades have introduced many technological innovations and materials in the field of surgery, prosthodontics and endodontics. In 1978 two Americans Apotheker and Jako constructed the first dental operating microscope. After three years it was available for purchase, but this event was met with great skepticism, and in the next decade few specialists decided to evolve towards microscopic dentistry. Only in 1990s first trainings using a microscope and first symposia on this topic were organised.
The Polish dentistry became interested in the possibility of extending the use of intra-surgical microscopy much later than doctors in the US. But now more and more professional dental offices are equipped with a dental microscope. So what are the advantages of using a microscope?
The microscope allows the doctor to look inside for a closer examination of the treatment area. This is particularly useful in the field of endodontics. The microscope makes it possible to locate outfalls of root canals, which often remain invisible to the naked eye. The number of canals and their location within the root are quite variable, and leaving a crude canal can lead to recurrent inflammation and pain. The occurrence of full or partial obliteration of canals, is also common. Their patency without control of the human eye can lead to serious complications, such as perforation – making a hole in the walls the walls of the root canal. Working in magnification reduces the risk of complication, as it allows us to control the area where the physician works. He sees the direction in which the drill moves. After completion of the root system of the tooth, a thorough evaluation of the degree of cleaning the inside of the canal is possible as well, the ideal state being the lack of any residual dentin, disinfecting paste and rinsing substances.
With the optical system of the microscope it is also possible to treat complications that can occur during endodontic treatment. The closure of perforation of the root and removing a broken tool are very precise procedures and require great manual skills of the operator. However, without high magnification it is impossible to visualize the perforating hole or find a broken piece of the file, not to mention their removal and suitable protection of the canal lumen.
Besides endodontics the microscope is also applicable in other fields of dentistry. It significantly increases the precision of procedures performed, and therefore is used in microsurgery and prosthetics, and even in the scaling of teeth. Prosthodontists reach for the microscope to accurately develop the pillars of the bridge and crown restorations, whereas surgeons need it in the root apex resection. Hygiene-related treatment performed at a magnification means greater precision in removal of the supra-gingival plaque and tartar.
The above cited examples of the use of microscopy show how much conventional procedures used in dental treatment have changed. With the microscope they have been improved to achieve better outcomes and solve clinical situations that only recently condemned the patient to remove the tooth. The dental operating microscope is undoubtedly a new chapter in modern dentistry, which may be in reach of every conscious patient. Caring for our patients, and offering services at the highest possible level, doctors in the Smile Design Clinic use such a microscope on a daily basis.