Dental Microscope Research Articles

Root canal morphology of mandibular first premolars in Saudi Arabian southern region subpopulation

Introduction: The aim of this study was to investigate the root canal morphology of Saudi Arabian mandibular first premolars by tooth clearing technique. Materials and Methods: One-hundred mandibular first premolars were collected from different dental schools and primary health care centers of the southern region of Saudi Arabia. Access cavities were prepared, the pulp tissue was dissolved, and teeth were subjected to clearing technique protocol. The transparent teeth were examined under dental microscope and following features were analyzed: number of roots, number of root canals, number of apical foramina, root canal configuration (Vertucci's classification), number of lateral canals, and intercanal communications. Results: Of the 100 mandibular first premolars, 80% had a single root, 18% had two roots, whereas 2% were three rooted. Seventy-two percent had a single canal, 26% had two canals, and 2% teeth had three canals. Seventy-three percent had a single apical foramen, 19% had two foramens, 2% had three apical foramens, and 6% had multiple apical foramina (apical delta). Sixty-nine percent had Type I, 8% had Type III, 4% had Type IV, 16% had Type V, 2% had Type IX, and 1% had an additional root canal configuration. Lateral canals were found in 38% and intercanal communications in 16% teeth. Conclusions: Although the majority of the study samples had a single root and one root canal, two roots were found in 18% and two canals in 26%. Such morphological variations should be taken into consideration to ensure successful root canal treatment of these teeth.

The application of dental microscope in root canal treatment and retreatment of maxillary first molar

The application of dental microscope in root canal treatment and retreatment of maxillary first molar

Fabrication of Two Different Probe Architectures for Ultra-Compact Image Sensors for Root Canal Observations

With the development of dental instruments, such as dental microscopes and cone beam computed tomography, the precision of current dental diagnosis and treatment has greatly improved. However, the observation of deep periodontal pockets, fractures near the root apex, and collaterals of root canals is difficult using these instruments. To solve these problems, we developed two types of micro-image sensors that can be used for the observation of root canals. The first image sensor is an external-irradiation probe that uses an external light source. This probe has high resolution and a wide field of view. The other sensor is an internal-irradiation probe, which can be used to observe an image and transmit the illumination light with a single probe. The external-irradiation probe has an image fiber with a diameter of 600 $\mu \text{m}$ and a gradient index (GRIN) lens. The internal-irradiation probe has an image fiber with a diameter of 300 $\mu \text{m}$ , a GRIN lens, and 40 optical fibers with a diameter of 40 $\mu \text{m}$ each as a light source. Using these probes, we captured the image of a resolution chart; line spaces with the widths of 10–100 $\mu \text{m}$ were observed using both types of probes. The evaluations of the visibility of the captured image showed higher measurement values than those of commercially available endoscopes. We will apply this ultra-compact image sensor to various fields besides dentistry, such as medical and industrial applications.

Retrieval of multiple separated endodontic instruments using ultrasonic vibration: Case report

Abstract This report describes the management of a complicated clinical case with three instruments fractured in one tooth. A 32-year-old patient presented with three ProTaper rotary files fractured in the upper right second molar (S2 and F2 in the disto-buccal canal and S1 in the mesio-buccal canal). A staging platform was prepared in the distal canal coronal to the fragments. Under dental microscope magnification, an Endo-4 ultrasonic tip was activated to dislodge the more coronal fragment (S2) by trephining dentine around the coronal aspect of the fragment. After 11 min, the fragment became loose and was removed. Following the same protocol and using an Endo-5 ultrasonic tip, the second fragment (F2) was removed in approximately 17 min. The first attempt to remove the S1 fragment from the mesio-buccal canal was not successful. An attempt to bypass this fragment using a K-file also failed. A second attempt using the ultrasonic technique resulted in a secondary fracture of the coronal aspect of the fragment. An Endo-5 ultrasonic tip was used to dislodge the fragment, which was successfully removed in 7 min. This report concludes that once a fractured file is bypassed, the instrumentation of a root canal is best completed with hand files. Clinicians should identify their limitations and consider referring cases that are beyond their abilities. Good experience and an appropriate armamentarium enable successful management of complicated cases. Ultrasonic vibration and dental microscope magnification contribute to successful removal of fractured instruments.

EFFECTIVENESS IN THE CURVE OF EIGHT TYPES OF ENDOSONIC TIPS FOR BROKEN INSTRUMENTS REMOVAL.

SUMMARY: The aim of the study was to compare the effectiveness of eight endodontic ultrasonic tips in removing stainless steel fragments from the curve of simulated root canals. Methods: Each of the instruments – K-files 25 (EMS), ET25 (Satelec), Redo2 (VDW), RT3 (EMS), CPR8 (Obtura Spartan), Proultra8 (Maillefer), E7 (NSK) and ENDO E3 (W&H) was used to remove 10 stainless steel fragments from the curve of simulated root canals (Dentsply-Maillefer) under magnification 10x and 16x with a dental microscope (OPMI Pico, Carl Zeiss). Success rate, working time and root canal enlargement were recorded and compared. Results: Success rates were as follows: K-files – 80%, ET25 – 90%, Redo 2 – 80%, CPR8 – 70%, Proultra8 – 80%, RT3 – 70%, Endo E3 – 60%, E7 – 50%. The differences were not statistically significant. Working time – mean values: K-files - 8,44 min, ET25 – 9,28 min, Redo 2 - 9,53, CPR8 – 11,01 min, Proultra8 – 10,31 min, RT3 – 11,57 min, Endo E3 – 15,34 min, E7 – 21,45 min. Endo E3 and E7 showed significantly longer working time, the differences between the other tips were not significant. Mean values of canal diameters were - K-files – 1,11 mm, ET25 – 1,29 mm, Redo 2 – 1,31 mm, CPR8 – 1,54 mm, Proultra8 – 1,51 mm, RT3 – 1,61 mm Endo E3 – 1,68 mm and E7 – 1,72 mm. The differences in canal enlargement between CPR8, Proultra8, RT3, Endo E3 and E7 were not statistically significant. Conclusion: Endodontic ultrasonic tips with smaller diameters and sharp working points worked faster and preserved root canal better.

SUCCESS FOR REMOVING OR BYPASSING INSTRUMENTS FRACTURED BEYOND THE ROOT CANAL CURVE – 45 CLINICAL CASES

SUMMARY: The aim of the study is to compare success rates for ultrasonic removal or bypassing endodontic instruments, fractured below the curve of root canals. Methods: 45 clinical cases – 30 MB and 5 ML root canals of mandibular molars, as well as 8 MB, 2 DB root canals of maxillary molars were selected from the authors’ private practice. 18 of the fragments are stainless steel files, 6 are rotary Ni-Ti files and 21 – lentulos. Fragments, to which visual access could be achieved by safe straightening of the root canal (26) were treated ultrasonically under dental microscope (OPMI Pico, Carl Zeiss) with magnification 10x and 16x. Bypass is chosen for fragments (19) without visibility. Results: Ultrasonic group: 22 of 26 fragments (84,61%) were totally removed, and full working length was consequently reached in 69,23% of the cases (18 fragments). Four fragments (15,38%) separated additionally from the vibrations and could not be totally ultrasonically removed. Bypass group: only 7 of 19 fragments (36,84%) could be successfully bypassed. Conclusions: Ultrasonic technique for broken instruments removal is significantly more successful than bypassing. Straight visible access to the fragment under dental microscope is crucial for successful fragments retrieval.

Learn to use a dental microscope

Learn to use a dental microscope

COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF THREE METHODS FOR PROXIMAL CARIES DIAGNOSIS – A CLINICAL STUDY

SUMMARY Aim: The aim of the presented study is to compare the effectiveness of the diagnosis with a dental microscope, laser fluorescence (DIAGNOcam) and X-ray examination in proximal caries diagnosis. Material and methods: Thirty-eight adult patients were examined. They were first examined with a dental mirror and a probe, under magnification 6.4 times. After that a diagnosis with DIAGNOcam was performed. Bitewing Xray images were administered. The data from the three diagnostic methods was compared using SPSS 16 package of Windows. The lesions that were diagnosed as involving dentin were then excavated which served as a confirmation of the diagnosis. Results: The results of the study showed that dentinal lesions were detected with a high degree of correlation with all three diagnostic methods. The visual examination seriously underestimated lesions involving only enamel. In these cases there was a good correlation between laser fluorescence and X-ray data. Conclusions: Based on the conducted study we could conclude that the diagnosis of proximal caries with DIAGNOcam is equivalent to X-ray, both being more accurate in cases with early lesions, compared to visual diagnosis.

Dental microscope in Nonsurgical Endodontics

Modern endodontics has essentially changed following the introduction of the dental microscope since 1990's. One of main advantage of using dental microscope in nonsurgical endodontic treatment is enhancing clinician's ability and quality of treatment through illumination and magnification. Scopes of dental microscope in nonsurgical endodontics are finding a missed or additional root canal and a tooth crack, management of procedural errors, and others. These improvements in technology will result in greater confidence in treatment and better success in clinical practice.

Is stopping of anticoagulant therapy really required in a minor dental surgery? - How about in an endodontic microsurgery?

Nowadays, oral anticoagulants are commonly prescribed to numerous patients for preventing cardiovascular accident such as thromboembolism. An important side effect of anticoagulant is anti-hemostasis. In a major surgery, the oral anticoagulant therapy (OAT) regimen must be changed before the surgery for proper post-operative bleeding control. However, in a minor dental surgery and endodontic surgery, the necessity for changing or discontinuing the OAT is open to debate. In this study, risks of the consequences were weighed and analyzed. In patients who stop the OAT, the occurrence of thromboembolic complication is rare but the result is fatal. In patients who continuing the OAT, post-operative bleeding can be controlled well with the local hemostatic measures. In the endodontic surgery, there are almost no studies about this issue. The intra-operative bleeding control is particularly important in the endodontic surgery because of its delicate and sensitive procedures such as inspection of resected root surface using dental microscope and retrograde filling. Further studies are necessary about this issue in the viewpoint of endodontic surgery.

The Removal of Fractured Instruments from Root Canals by Using a Dental Microscope and Ultrasonic Instruments

The Removal of Fractured Instruments from Root Canals by Using a Dental Microscope and Ultrasonic Instruments

Removal of Broken Files from Root Canals by Using Ultrasonic Techniques Combined with Dental Microscope: A Retrospective Analysis of Treatment Outcome

Introduction The objective of this study was to assess the clinical outcome after removal of a broken file from root canal by using ultrasonic techniques and to evaluate various factors that might influence the outcome. Methods One hundred two patients with 102 teeth with a broken file in the root canal, treated between 2004 and 2008, were contacted for follow-up examination 12–68 months after treatment (median, 28 months). Outcome was assessed on the basis of clinical and radiographic criteria by calibrated examiners and dichotomized as healed or disease. The result was analyzed statistically by Pearson or Fisher exact test and multivariate logistic regression. Results Of 66 teeth examined (64.7% recall), 81.8% were healed. Stepwise logistic regression analysis revealed that inadequate root canal filling was a statistically significant factor in predicting failure of successful healing. The cases with removal of broken files had a higher healing rate than those with broken files left in the root canal, but the difference was not statistically significant ( P > .05). There was no significant difference in outcome related to presence or absence of perforation, although the rate of healing was greater in teeth without perforation. Other factors including age, sex, tooth type, apical status, position of segment, and type of restoration did not affect prognosis. Conclusions Treatment outcome after the use of ultrasonics for removal of broken files was favorable. Adequate root filling has a more substantial impact on treatment outcome than the other factors.

Safety of laser use under the dental microscope

The aim of this study was to investigate the safety of laser use under the dental microscope. Nd:YAG, Er:YAG and diode lasers were used. The end of the tips was positioned at a distance of 5 cm from the objective lens of a dental microscope. Each eye protector was made into a flat disc, which was fixed on the lens of the microscope. The filters were placed in front of the objective lens or behind the eye lens. Transmitted energy through the microscope with or without the filters was measured. No transmitted laser energy was detected when using matched eye protectors. Mismatched eye protectors were not effective for shutting out laser energy, especially for Nd:YAG and diode lasers. None or very little laser energy was detected through the microscope even without any laser filter. Matched filters shut out all laser energy irrespective of their positions.

Treatment Outcome of Periapical Surgery using Dental Microscope Based on Diagnosis with CBCT (Advanced Dental Technology)

Treatment Outcome of Periapical Surgery using Dental Microscope Based on Diagnosis with CBCT (Advanced Dental Technology)

Apicoectomy aided by dental computed tomography and dental microscope : A case report

Apicoectomy aided by dental computed tomography and dental microscope : A case report

Pre‐clinical endodontics: a survey amongst German dental schools

To evaluate the state and level of pre-clinical endodontic education in German dental schools and to evaluate differences with regard to intensity and extent of teaching, time devoted to teaching pre-clinical endodontics, personnel resources in teaching and technical equipment. Twenty-eight questionnaires were e-mailed to those in charge of pre-clinical endodontic education in German dental schools. The extent of education, the student-teacher ratio, the teaching content as well as the application of teaching materials and technologies were asked. If, after 4 weeks, no response had been received, the questionnaire was sent out by e-mail again. In the absence of a reply, a phone call was made to the corresponding university to conduct the survey by phone. With feedback from 27 of 28 dental schools, the response rate was 96%. Pre-clinical endodontic education at German universities varied considerably. Theory classes ranged from 5 to 30 h (13.3 h mean), practical classes from 12.5 to 60 h (45.4 h mean). The student to staff ratio varied between 9 : 1 and 30 : 1 (16 : 1 mean). Forty-eight per cent of the universities had a specialist in endodontics or a teacher with a special interest. A dental microscope was available for pre-clinical teaching purposes in 38% of the universities. The majority (63%) of universities taught root canal preparation with rotary nickel titanium instruments. Pre-clinical endodontic education varied considerably between German universities because of differences in programme design, staff and course content.

Prognosis of Periapical Lesions Treated by Retrograde Root Canal Filling under Examination with 3DX and Dental Microscope

Prognosis of Periapical Lesions Treated by Retrograde Root Canal Filling under Examination with 3DX and Dental Microscope

The effect of radiation on the response of dental pulp to operative and endodontic procedures: An experimental study

Thirty-six 56-day-old male Sprague-Dawley albino rats served as two groups of experimental animals. Group 1 was irradiated with 400 rads delivered as total-body radiation from a cesium source. Group 2 served as the control group and was not irradiated. Three weeks later, the dental microscope was used to facilitate various dental procedures in both groups of animals (cavity preparation filled with zinc oxide-eugenol, pulp exposure capped with zinc oxide-eugenol, and pulp exposure left open). Two animals for each procedure from Groups 1 and 2 were killed at time intervals of 2, 4, and 8 weeks. The results showed that (1) radiation at this dose resulted in a depression of the normal response of the dental pulp to the trauma and infection induced by pulpal exposure, (2) there were no pathologic changes in the untreated molars of the irradiated animals, and (3) the use of the dental microscope greatly facilitated cavity preparation in the molars of rats.

Apical surgery with the dental microscope

P eriapical .pathology due to the egress of toxins from infected or degenerative pulps has long been known to respond to endodontic therapy. Two forms of treatment may be employed. The first and most common has been termed the conventional or nonsurgical approach. Here, the operator strives to clean, shape, and then hermetically seal the root canal system. Various investigators have described the success rate to range between 82% and 95%.‘** In cases of failure with this first approach, or in instances in which canals have become obstructed by posts, broken instruments, calcifications, etc., or for some other reasons, the second form of treatment, surgical endodontics, is performed. Here great precision and accuracy are necessary to flap the tissue, remove as little bone as necessary, curette the periapical area, bevel the root tip, make an apical preparation, and seal the apex with amalgam (retrograde filling). In addition to performing thorough treatment, the dentist must take care to provide minimal trauma to the hard and soft tissues.

The applications of the dental microscope: preliminary report.

AbstractThe application of a dental microscope to the examination of the oral cavity and teeth, the preparation of cavities and crowns, root canal therapy, and periodontal and oral surgical procedures is discussed. The combined use of the microscope and laser and the microscope and videotape equipment are also discussed.