Thanks to microscopes, we are in position today to locate hidden canals, prepare obliterated canals and remove fractured instruments. In microsurgical endodontics, if you look at it closely, the microscope enables us to carry out this treatment "lege artis".
Various cases from endodontics excellently show the treatment possibilities opened up by the OPMI. In conventional areas, the OPMI makes it possible to locate obliterated canals, and even repair and fill them; to look for and display the fourth canal in the upper and lower molars; to remove fractured instruments, while protecting the tooth as much as possible, as long as they can be seen using the OPMI; to remove posts and old root fillings, enabling the elimination of the cause of the inflammation.
Using the OPMI in surgical endodontics clearly highlights what was done wrong in the past, and enables us to reduce the failure rate by cracks, isthmuses and fractures.
Dr. Wolf Richter, Munich
Dental Newspaper 1/2002
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Using the OPMI is not the end all, be all, and it is not an unconditional guarantee of success in endodontics. However, the success of treatment using visual aids has become more calculable. With the ability to see better, you can give the patient clear choices. Is it "worth it" to save the tooth, and can it be justified based on time or financial points of view?
- There are three considerations to take into account here:
- Pre-existing endo-equipment;
- endodontic knowledge and experience;
and a fair calculation based on the expected amount of time.
However, today's gold standard should not be a reason to despair, but rather enticement to expand your working area of endodontics in the office, or send a patient to a colleague who specializes in such treatments.
Dr. med. dent. Norbert Linden
DZ 4/2002
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The introduction of microscopes into endodontics in the early nineties brought on a renaissance in endodontics that led to new and exciting discoveries and the blossoming of new ideas and techniques. When the surgical operating microscope was introduced in endodontics in USA, it was a historical landmark for advances in the filed of dentistry. The microscope proved to be an invaluable instrument, allowing endodontists to render treatment for problems which were previously thought to be impossible to treat.
Endodontists use the surgical operating microscope because the illumination and magnification are greater than that achieved with overhead lamps and loupes. Under the microscope the endodontist sees the procedure being done in clear magnified detail, thereby eliminating any "guess work". There is no colour distortion in microscopic images. Natural colour of tissues are faithfully reproduced in its images and together with high definition and clarity, it is much easier to differentiate tissues that look somewhat similar.
Dr. Leslie Ang
Reprinted from Dental Asia July 2002
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Modern man is seldom amazed. But there are still fascinating moments in dentistry. For me, looking through a surgical microscope is among these. The root canal, once ruled by darkness, is suddenly illuminated and reflects in bright light, opening its anatomical wonder of side canals, branches, notches, furrows, colored shadows and secret passages. In many cases, the ominous Foramen physiologicum becomes visible and can almost be touched, allowing the periapex to be anticipated.
The main advantage of the surgical microscope compared to all loupe systems is that it is aided by coaxial illumination. This means that illumination of the field of view is practically in the line of sight. A minimal angle to the observation direction is given to deliberately create a shadow that significantly simplifies the spacial depth effect for the human eye. This is particularly meaningful and important in deep operating areas, as in root canals.
Without a doubt, the greatest revolution with microscopes was in root-tip resection.
Today, using the trifecta of magnification - illumination - instrumentation, an excellent, retrograde, microsurgical root-tip resection, can be carried out under a surgical microscope with optimal illumination and by using ultrasound-supported retrograde treatment and a special micro-insturment. The success rate using this method was 96.8 percent with a mean healing time of 7.2 months for the 94 cases observed over one year.
New horizons were, and will still be opened for surgical microscopes in endodontics. Without a doubt, the quality of the results will increase.
Univ.-Prof. Dr. Michael A. Baumann
ZMK 11/00
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With the naked eye, even a young doctor can’t see all the details in a surgical field of only a few square millimeters. The surgical microscope is the current pinnacle of technology. It can be used to find the entrance to canals, for visual control for revisions and for cases with complex anatomical situations or obstacles in the canal path. The advantage of the surgical microscope is the coaxial injection of the light source and the variable magnification range with good depth of field. The design of the microscope enables ergonomic working conditions and fatigue-free viewing as the eye does not need to acclimate to the near area.
PD. Dr. Richard Stoll
Dental Magazin 4/2003
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After all, it can certainly be traced back to modern procedures and the implementation of the surgical microscope, stated Hoskinso in 2002 about a 78 percent success rate for orthograde revision.
The basis for a meaningful revision is still the surgical microscope, and Dr. Clifford Ruddle is in good company here.
Dr. med. dent. Hans H. Sellmann, Marl
DZW Woche 42/03
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The resolution of the human eye and the illumination of the often hard to reach working field are limiting factors for precision dental treatment. With proper training, you can carry out movements to a tenth of a millimeter - but you can still only treat what you can see! For that matter, it is amazing that the surgical microscope has only been widely used in dental offices since the mid-nineties - and that primarily in endodontics and periodontics.
Typical indicators for using a microscope are endodontic treatments and microsurgical procedures - particularly in periodontics and root-tip resections.
The surgical microscope is a must-have tool, e.g. in endodontics for viewing obliterated root canal entrances, for revision treatment and when looking for that almost-always present 4th root canal in the maxillary molars. Together with the new preparation and filling techniques, the results of endodontic treatments can be decisively improved.
Microsurgical operating techniques lead to accelerated healing, permit a good predictability of the result and improve the prognosis, e.g. for root-tip resections.
Working with a microscope increases the visual control and, as a result, the quality of the result, to a completely new level. Dr. Christoph Huhn
ZWP 7+8/2003
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Optical confirmation, combined with high quality in daily work and the satisfaction of my patients was the main reason for my interest in a surgical microscope.
Andreas Morakis, Mainz
Dental Magazin 2/2003
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A root-tip resection should only be done when using a surgical microscope. While orthograde, endodontic treatments in literature state a success rate of 90 percent, conventional retrograde surgical treatments only reach about 60 percent. This is due to the fact that the anatomy of the tooth is insufficiently seen by the ‘naked eye’ and the smallest canal structures are only inadequately, or not at all, cleaned and closed.
Dr. Uwe Radmacher, Dr. Markus Lewitzki; Lamerptheim
Oralchirurgie Journal 3/2003
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Dr. Dennis A. Shanelec, a pioneer in microscopes, sees the benefit of optical magnification in the refinement of surgical techniques. The goal is to achieve the highest possible precision while providing maximum protection to healthy tissue. The advantage lies in minimal trauma to the treated tissue and an increased security in achieving the desired result.
For patients, this means less pain, shorter healing times, greater probability of reaching the desired result (e.g. as regards aesthetics) and better long-term results.
Visual aids reduce surgical stress as the enable the calculation of unforeseen failure factors such as fractures, inflamed tissue and tooth structure variations.
Many things that remain unseen without a microscope (filling imperfections, rough tooth enamel, prosthetic deficiencies, skin changes), become visible. The dentist has a whole new treatment spectrum at his doorstep.
Walter Wille-Kollmar
Dent Implantol 6, 28-33 (2002)
top |  Dr. Wolf Richter
Dr. med. dent. Norbert Linden
Dr. Leslie Ang
Univ.-Prof. Dr. Michael A. Baumann
PD. Dr. Richard Stoll
Dr. med. dent. Hans H. Sellmann
Dr. Christoph Huhn
Andreas Morakis
Dr. Uwe Radmacher, Dr. Markus Lewitzki
Walter Wille-Kollmar |