Stefan M. Luger

Magnification is essential for performing not only endodontic procedures, but almost any other dental procedure one can imagine, except perhaps Orthodontics. A microscope is absolutely the best modality for consistent accurate visualization for dental procedures. Anything else is just a compromise.

Microscopes are important in four main areas:

1. MAGNIFICATION

Microscopes provide multiple telescopic magnifications with a twist of a dial, from 3x to 20x. The higher magnification provided by microscopes allow for a wider field of view and a deeper depth of field than loupes.

Although loupes are available with magnification above 3x, there are drawbacks.  Loupes have only a single magnification factor.  Additionally,  loupes with any factor above 3x have increasingly longer and heavier lenses, with a progressively smaller field of view.  The additional weight makes holding one’s head steady a challenge, and the use of higher magnifications becomes difficult at best.

2. ILLUMINATION

Whenever the degree of magnification is increased,  the available light is spread out. For this reason anything under higher magnification appears darker. Additional light is required to compensate for this phenomenon. In order to achieve adequate illumination with loupes, one should purchase the optional headband light source which provides the spot illumination needed. Microscopes on the other-hand have an integrated, through the lens, bright fiber-optic light source. This light source completely eliminates shadows because it incorporates a coaxial (line of sight) light path that is always directed where you are looking. Some microscopes even have a built-in curing light filter that prevents light activated composites from polymerizing while using the scope for general dental procedures.

3. ERGONOMICS

Microscopes really deliver on the promise of comfortable sit-down-dentistry. With a scope, it is no longer necessary to contort and bend your body to obtain good visualization. With proper microscope training, one can sit at the 12 o’clock position even while working with mandibular molars by learning to bring the patient to you, instead of you bringing yourself to the patient. Under a microscope, subtle patient head movements are all that is required for proper patient positioning to affect a more comfortable operating posture.

4. IMAGING

One may add an integrated video camera and a monitor to the scope for image capture. A scope with a camera will fulfill the same function as does an intra-oral camera, but with the advantage of imaging done in “real time”. While working with the scope, you don’t have to stop in the middle of the procedure to get the wand, find the tooth, focus, and capture the image. What you see is what you get in "live action video". The image can be saved to the computer, emailed, printed on a video or computer printer, or even recorded on a VHS or DVD. Additionally you can use a digital still camera.

Justifying a proposed treatment plan to an insurance company is facilitated when a printed picture accompanies the plan.

5. PATIENT ACCEPTANCE

Viewing their own teeth as seen through a scope is an impressive patient education tool that portrays the dentist as state of the art. They become participants in their treatment planning process and actually help suggest work they want to have completed. They are impressed with the scope and because they have participated, have ownership and agreement of their proposed treatment plan.

6. COST

Microscopes need not be expensive. You can acquire a basic entry-level unit for about $5,795 but for the most part, dentists are purchasing units in the $11K - $16K price range. For approximately $300 a month on a lease, you too, can be the user of a scope. That's less than the fee for one RCT. In my warped way of thinking, it costs you more money NOT having a scope than having a scope, because of all it could do for you. If you are interested in becoming a scope user, feel free to contact me.