Loupe Magnification Research Articles

Dental students’ Performance and Perceived Experience with Magnifying Dental Loupe

Introduction: Magnifying dental loupes have been reported to improve performance and ergonomics among different dental care practitioners. However, there is little evidence to support its use among novice dental students. In this study, we correlated the use of magnifying dental loupes and first-year dental student’s performance in preclinical competency assessments. In addition, we evaluated the students’ perceived experience with the use of magnifying dental loupes. Materials and methods: The students’ performance and the students’ perceived experience with the use of magnifying dental loupes were assessed. To assess the students’ performance, we compared the competency assessment scores of the students either using dental magnifying dental loupes or not. A linear mixed-effects model was used to test the effect of magnifying dental loupes on students’ performance in cavity preparation classes I, II, and III. To assess the perceived experience with the use of magnifying dental loupes, 109 first-year dental students were surveyed. Results: Magnifying dental loupes showed a positive and significant correlation with student’s increase in performance. Students who used magnifying dental loupes have shown a positive difference of 2.8 points (p= 0.029). However, as multiple competency assessments were evaluated, the overall students’ scores varied despite the fact of using or not magnifying dental loupes. In addition, first-year dental students positively perceived the use of magnifying dental loupes. Conclusion: Magnifying dental loupes increased first-year performance in classes I, II and III preparation competency assessments.

Repair Bond Strength of Aged Composite Resins Using Different Surface Treatment Protocols.

This study evaluated shear bond strength (SBS) of thermally aged composite resins repaired using different surface protocols. Four-hundred composite resin samples were made using the following materials (100 samples per material): Filtek Z350XT (FXT); Spectra Smart (SSM); IPS Empress Direct (EDI); and Forma (FOR). Each group's samples were then divided into 10 groups (n = 10 samples per group): G1: no surface treatment; G2: phosphoric acid-etching + universal-adhesive (PU); G3: surface roughening + PU (RPU); G4: RPU + silane (RPSU); G5: surface roughening + hydrofluoric acid-etching + universal adhesive (RHU); G6: RHU + silane (RHSU); G7: dry sandblast + PU (DsPU); G8: DsPU + silane (DsPSU); G9: wet sandblast + PU (WsPU); and G10: WsPU + silane (WsPSU). G1 was freshly repaired, and G2 to G10 were thermally aged before repair. Specimens were tested for SBS, and the failure type was observed with a magnifying loupe. Representative images were obtained using a scanning electronic microscope. Data were analyzed by two-way analysis of variance and Tukey post hoc tests (P = .05). Differences were detected among different surface treatments and among different composite resins with equal surface treatments (P < .05). SBS means ranged from 10.48 (FOR:G2) to 20.70 (FXT:G7). The highest SBS values were seen in G7 to G10 (P > .05), while lowest values were generally observed for G2. G1 showed higher results compared to G2 (P < .05), except for EDI (P > .05). Most failures corresponded with cohesive type. In general, thermally aged composite resin presented a decreased repair bond strength potential when no additional surface treatment was applied. Sandblasting improved the SBS of repaired aged composite resins.

New surgical frontiers for 4K 3D-exoscope in paediatric head and neck surgery.

To define the interest, advantages, and disadvantages of the use of a 3D-exoscope in paediatric ENT surgery. Four surgeons with experience in paediatric surgery completed a questionnaire following each surgery performed under 3D-exoscope to evaluate the contribution of the tool compared to the usual practice (microscope or magnifying loupes). Surgeries were separated into three groups: otology, transoral and cleft palate surgery, and open head and neck surgery. Between June 2021 and June 2022, 151 paediatric surgeries were included in this study. Among them, 93 (62%) otologic surgeries, 35 (23%) transoral surgeries, and 23 (15%) head and neck surgeries were performed. The median age at surgery was 68months (interquartile range 19-135months). For otologic surgeries, the mean scores (/100) for the contribution of the exoscope compared to the microscope were 68.4(± 23.2). For transoral and cleft palate surgery, the mean score (/100) for the contribution of the use of the exoscope compared to the magnifying loupes was 92.9 (± 8.6), whereas for open head and neck surgeries, the mean score (/100) was 89.5 (± 7.2). 3D-exoscopy appears to be a relevant tool for paediatric head and neck surgery, applicable in otologic, transoral, and cervical fields. It presents educational and ergonomic advantages and improves surgical team communication.

36. Does the use of hand-held dermatoscope smart phone photography help in achieving clear peripheral margins in cutaneous malignancy – A Preliminary Study

Use of Dermatoscope is well recognised for the assessment and diagnosis of cutaneous malignancies. Peripheral margins are usually identified under good lighting and use of magnification loupes before excision. Limiting extent of surgical resection on the face in key cosmetic areas without compromising tumour excision margins is sometimes a challenge. Aim for our study to identify and mark peripheral margins pre-operatively with the use of handheld dermatoscope smart phone photography.

The effect of loupe magnification on occurrence of duct complication after liver transplantation: a single-center experience

The effect of loupe magnification on occurrence of duct complication after liver transplantation: a single-center experience

Anatomic study of an anterior portal for percutaneous internal fixation of capitellum fractures.

Fractures of the capitellum are uncommon and difficult to treat surgically. Capitellar open reduction-internal fixation uses a lateral open approach with posterior-to-anterior or anterior-to-posterior screw fixation. We investigated the use of an anterior portal for placement of anterior-to-posterior screw fixation through cadaveric measurement of the anatomic relationships from an anteriorly to posteriorly placed Kirschner wire (K-wire) to anterior elbow structures and calculated the percentage of articular surface accessed from the anterior portal. Eight fresh-frozen cadaveric elbows without radiographic or cutaneous evidence of prior trauma or surgery were used for this study. An arthroscopic proximal anteromedial portal was cannulized, and the radiocapitellar joint was evaluated. A single 1-cm portal was placed 1 cm distal to the elbow flexion crease and based lateral to the biceps tendon. The location of the portal was confirmed with a spinal needle, and blunt dissection with a hemostat was performed down to capsular tissue and for arthrotomy. A spinal needle sheath was threaded over a blunt switching stick and served as a cannula for placement of a 0.062 K-wire. Articular mapping was performed with cartilage scraping by the K-wire; the K-wire was then placed at the perceived center along the proximal-to-distal and radial-to-ulnar axis of the capitellum. Fluoroscopic confirmation of the wire's location was performed. Under loupe magnification, anatomic dissection was performed and the shortest distance measurements were recorded with digital calipers from the K-wire to the dissected structures. Capitellar articular measurements were recorded, in addition to the articular area defined by the K-wire. Data analysis was performed, and the average distance and standard deviation (in millimeters) were calculated. For structures that were pierced by or touching the K-wire, the distance was recorded as 0.1 mm. The average distance from the K-wire to the radial, lateral antebrachial cutaneous, and median nerves was 1.8 mm, 11.5 mm, and 28.0 mm, respectively. The average distance from the median cubital vein and biceps tendon was 3.7 mm and 13.4 mm, respectively. The pin track pierced the brachioradialis and supinator muscles in all but 1 specimen. The average capitellar articular surface marked was 39.1% of the calculated articular footprint of the capitellum. The anterior portal to the capitellum is directly adjacent to the radial nerve and lateral antebrachial cutaneous nerve, where each is susceptible to injury. We recommend blunt dissection and insertion of a cannula to allow drilling and placement of internal fixation in a relatively safe manner with respect to neurovascular structures.

Management Thresholds for Molars With Occlusal Noncavitated Caries Lesions

AimThere is sparse research on the effect of factors related to the dentist and patient in the caries management decision-making process. This in vitro study explored the influence of factors related to dentists and patients on the management decision of occlusal noncavitated caries lesions in children. Materials and methodsFive investigators in the specialties of dental public health (DPH), paediatric, prosthetic, and operative dentistry and a general dentist (GDP) participated in this study. Initially, the investigators were asked to independently assess the occlusal surfaces of 175 noncavitated permanent molars and choose a management recommendation using 2 caries risk patients’ scenarios. After 1 month, investigators were trained and calibrated to use the International Caries Detection and Assessment System (ICDAS) scoring system. Then, they examined the same teeth, recorded the highest/worst ICDAS score, and chose a management recommendation. Two weeks later, the investigators repeated the teeth examination using magnification loupes and again chose a management recommendation. The teeth were sectioned to study the relationship between the presence of caries and the management recommendations. ResultsFor the low– and the high–caries risk scenarios, ICDAS training increased the operative intervention by 20% to 27% and 14% to 22%, respectively, for both the GDP and the paediatric dentist (P < .0001). For the low–caries risk scenario, using the magnifying loupes increased the operative recommendations for the DPH, GDP, and the operative dentist by 5% to 23% (P < .05). Compared to the low–caries risk scenario, teeth for patients with high caries risk received more surgical interventions (9%-30%) at all examination conditions for the GDP and the paediatric and operative dentists (P < .0001). ConclusionsFor occlusal noncavitated caries lesions, enhancing dentists’ caries detection skills had a significant impact on decisions of surgical intervention. This also influenced the appropriateness of the treatment recommended for the different caries risk groups.

Surgical Outcomes of Minimally Invasive Transforaminal Lumbar Interbody Fusion Using Surgical Microscope vs Surgical Loupes: A Comparative Study.

Minimally invasive transforaminal interbody fusion (MIS-TLIF) is an effective procedure for lumbar spine diseases. The procedure can be done using a surgical microscope (SM) or surgical loupes (SL) magnification. However, there are no studies that compared outcomes between using these 2 magnifying devices in the MIS-TLIF procedure. The purpose of this study was to compare clinical outcomes, perioperative complications, and radiographic parameters of MIS-TLIF using SM compared with SL magnification. We included all patients undergoing 1-level MIS-TLIF between January 2017 and December 2019. Type of magnification (SM vs SL), operative time, blood loss, perioperative complications, cross-sectional area of the spinal canal, and fusion rates were analyzed. Clinical outcomes measurement using the visual analog scale (VAS) and Oswestry Disability Index (ODI) were compared between groups. A total of 100 patients had underwent MIS-TLIF (SM group: 62; SL group: 38). Operative time (SM: 182.7 ± 41.5 vs SL: 165.6 ± 32.6 minutes, P = 0.043) was significantly shorter in the SL group, with a mean difference of 17.2 minutes and a 10.4% increase in operative time between SL and SM. Blood loss (SM: 187.4 ± 176.4 vs SL: 215.6 ± 99.4 mL, P = 0.36) was not different between groups, with a mean difference of 28.2 mL. Both the SM group and SL group demonstrated no significant differences in improvement from baseline in VAS back, VAS legs, ODI score, and cross-sectional area of the spinal canal. There was also no significant difference in complication rates and fusion rates between groups. Our study found no difference between intraoperative use of SL compared with SM in clinical outcomes through the 12-month follow-up timepoint. However, the use of SM resulted in an increased average operative time of 17 minutes compared with the SL group. Intraoperative use of SM and SL magnification in MIS-TLIF provides similar outcomes except prolonged operative time in the SM group.

Soft tissue reconstruction in traumatic nasal defects by forehead flap: A tertiary care centre experience

Forehead flap is the gold standard for nasal soft tissue reconstruction. The nose is a complex three-dimensional structure and along with the eyes, represents a major aesthetic focus of the face. The aim of this study is to review the use of forehead flap in nasal reconstruction and prospectively evaluate the outcome of treating nasal defects as an easy, effective and economical treatment in the Indian population.Material and Methods: This prospective study was conducted from March 2020 to May 2022. Patients with subtotal nasal defect who were above 18 years of age, and patients who were willing to give informed consent for treatment. Each participant underwent surgical debridement under loupe magnification combined with forehead flap cover after a full clinical assessment.Results: Twenty three participants were included in this study with an age range of 18–62 years with mean age (36.1±8.71). Out of these 6(26.1%) were female and 17(73.9%) were males. The defect were located over the dorsum and lateral nasal wall in 3 participants (13.1%), tip in 2(8.7%) patients, ala in 1(4.3%) patients and involved multiple subunit in 17(73.9%).Conclusion: The forehead flap represents the ideal reconstructive choice in patients with nasal defects. It has good textural, thickness and color match when compared with the recipient site tissues, with minor complications.

An unusual cause of tarsal tunnel syndrome: Schwannoma of the posterior tibial nerve; a rare cause and rare localization.

IntroductionSchwannoma of the posterior tibial nerve is extremely rare.Case presentationA 25-year-old female with a one-year history of left foot pain is presented. Clinical and radiological findings were in favor of a tarsal tunnel syndrome caused by a schwannoma of the posterior tibial nerve, prompting the patient to undergo surgery. We performed a complete excision of the tumor with the aid of a loupe magnification. At the last follow-up, the patient did well, with no recurrent pain and no neurological squeals.DiscussionThe diagnosis of a tibial nerve schwannoma can often be difficult as, in the early stages, a mass may not be palpable and symptoms are often non-specific because of the slow-growing soft tissue mass.ConclusionAlthough schwannoma is a rare cause of tarsal tunnel syndrome, it should be kept in mind by physicians, especially in cases of chronic unexplained foot pain with a positive Tinel's test.

Ocular morbidity pattern in Kashmir – A hospital-based study

In recent years, some epidemiological surveys of common eye diseases and prevalence and risk factors for blindness and low vision have been carried out in various parts of India. Still, very little information is available on the prevalence of ocular diseases in Jammu Kashmir, particularly those who live in the remote areas of Kashmir.A total of 234 patients attended the eye OPD, which constituted the study's sample size. The patient was screened, keeping COVID-19 guidelines in mind. Sanitization and social distancing were maintained. Visual acuity was evaluated using Snellen's chart for the literates and illiterate E chart for the illiterates from 6m. Both Objective and subjective refraction was performed on a patient to determine refractive error. Anterior segment was examined with torchlight and magnifying loupe &amp; slit lamp if and where necessary. The fundus was examined on a slit lamp using the +90D or with Direct Ophthalmoscope. Refractive error was quantified in terms of spherical equivalent. The visual acuity of a patient was converted into LOG MAR for statistical calculation.A total of n=234 patients were examined for evaluation of ocular morbidity, of which 97(41.45%) were male %, and 137(58.55%) were female with a male to female ratio of 7: 10. The mean age of the patients was 36.96 ± 23.93 years.56.8% were diagnosed with refractive error and 30.8% with cataracts. There was a statistically significant relationship between increasing age and cataracts.As Refractive error and cataracts were the emerging ocular morbidity, the population is living in the remote areas of Kashmir, especially children, should get quality eye care.

Do magnification loupes affect the precision of cavity preparations made by undergraduates? A randomized crossover study

BackgroundEvidence on the effect of magnification devices on procedure quality in restorative dentistry is scant. This study therefore aimed to assess, under simulated clinical conditions, if magnification loupes affect the quality of preparations carried out by undergraduate dental students.Methods59 undergraduate dental students underwent two visual acuity tests, based on which they were divided into a “low visual acuity group” (visus < 1) and a “good visual acuity group” (visus ≥ 1). In a randomized crossover experiment, participants performed a two-dimensional S and a three-dimensional O figure preparation with a dental handpiece on standardized acrylic blocs designed for preclinical restorative training. Each participant carried out the preparation tasks twice, once with magnification loupes (2.5×) and once without. Two blinded investigators independently evaluated parameters of preparation precision. Data were analyzed using Spearman rank correlation coefficients, intra-class correlation coefficients, and Wilcoxon rank-sum tests (α = 0.05).ResultsParticipants from the “low visual acuity group” did not show a statistically significant improvement in accuracy when they used magnification loupes for the S figure preparation (p ≥ 0.0625). Participants from the “high visual acuity group” obtained a higher level of accuracy (p ≤ 0.0012) when they used magnification loupes for the S figure preparation. The use of magnification loupes had no statistically significant effect on the accuracy parameters of the O figure cavity preparations (p ≥ 0.1865). Participants with high visual acuity achieved only a marginally better accuracy than participants with a visus < 1.ConclusionsThis study suggests that loupes with 2.5× magnification increase the accuracy of two-dimensional preparations while they have no significant effect, favorable or otherwise, on the accuracy of complex, three-dimensional cavity preparations of untrained dental students.

Clinical implications of the distinct anatomy and innervation of the long head biceps tendon.

The proximal long head of the biceps tendon (LHBT) has been recognized as a well-known cause of anterior shoulder pain. Previous studies have identified a heterogeneous distribution of nerve fibers in the tendon, with a higher abundance of fibers in the proximal and distal thirds of the tendon. This suggests that the proximal portion of the long head biceps tendon may have a different source of innervation than the distal portion. The purpose of this study was to review the innervation of the superior shoulder and identify the proximal source of sensory innervation of the LHBT. The relevant hypothesis was that the suprascapular nerve (SSN) was the proximal source of sensory innervation to the LHBT. Gross and microdissection of eight fresh human cadaver shoulders were performed, with a focus on the distal articular branches of suprascapular nerve (SSN). Utilizing 3.5× magnification loupes, the medial subacromial branch (MSAb), lateral subacromial branch (LSAb), and posterior glenohumeral branch (PGHb) were identified and followed distally to their terminal branches. In all specimens, terminal branches of the lateral subacromial branch supplied the proximal LHBT and the superior labrum. Terminal branches of the posterior glenohumeral branch supplied the posterosuperior labrum and, to a lesser extent, the labral attachment of the LHBT. These findings confirm branches of the suprascapular nerve as the proximal source of sensory innervation to the LHBT. Identification of the suprascapular nerve as a source of proximal innervation of the LHBT may influence clinical decisions related to nonsurgical and surgical intervention, nerve blocks, and nerve ablation procedures.

Defining the Digit-Specific Confluence of the A1 Pulley

Variations in the description of the flexor pulley system exist, particularly in whether the A1 and A2 pulleys represent discrete or confluent entities. This has potentially important clinical relevance at the time of A1 pulley release for symptomatic trigger finger, given the goal of adequate release without overrelease. The purpose of this study was to determine the relative prevalence of confluent A1 pulleys on a digit-by-digit basis employing 2.5× loupes alone, thereby simulating a clinical surgical environment. Cadaveric anatomic specimens underwent flexor pulley system dissection under 2.5× loupe magnification by 2 hand surgeons. The presence of pulley confluence and length (measured from the proximal aspect to the distal aspect) was recorded and compared on a digit-to-digit basis. Forty-five digits, comprising 9 adult forearm or hand specimens (5 right and 4 left) obtained from 6 donors (4 men and 2 women, age: 67 ± 8 years), were dissected. A total of 19 confluent A1 pulleys were encountered, with notable digit-by-digit variation in the prevalence of confluent pulleys. There were 0 confluent pulleys observed in the thumb, compared with 6 confluent pulleys observed in the middle finger. The average overall A1 pulley length was 5.0 ± 1.5 mm, with a similar pulley length observed between the digits. A1 pulley confluence varies on a digit-to-digit basis, with no observed confluence in the thumb and the most common confluence observed in the middle finger. In the setting of intraoperatively observed pulley confluence, we suggest pulley release under traction in order to develop the plane between the A1 and A2 pulleys and, thus, confirm the complete and isolated release of the A1 pulley.

A multinational survey characterizing the use of surgical magnifying loupes in dermatological surgery.

The use of surgical loupes has not been well-documented in dermatological surgery. An online questionnaire was developed to characterize the use of loupes in dermatological surgery. The questionnaire was circulated to the memberships of the British Society of Dermatological Surgery, the European Society of Micrographic Surgery, and the Australasian College of Dermatologists. Responses were analyzed with a mixed methods approach using quantitative data analysis and inductive content analysis. One-hundred twenty-five valid responses were received from 20 nations. Most respondents were from England (40%; 50/125), Australia (16%; 20/125), and the Netherlands (14.4%; 18/125). Overall, 71.2% (89/125) of respondents were consultants/Facharzt/attending. Furthermore, 55.2% (69/125) of respondents were Mohs surgeons. In dermatological surgery 38.4% (48/125) of respondents used surgical loupes routinely. The mode magnification level for loupes was 2.5× (67.5%; 27/40), with 3× second place (12.5%; 5/40). Exactly half (20/40) used through-the-lens style loupes and 40% (16/40) used flip-up-loupes. Inductive content analysis of the 51 free-text responses from nonloupe users uncovered several deterring factor themes, including expense (18/51), can manage without/don't need (14/51), and narrow field of view a(11/51), and uncomfortable/too heavy (9/51). This is the first time the use of surgical loupes in dermatological surgery has been internationally characterized.

Effect of magnification factor by Galilean loupes on working posture of dental students in simulated clinical procedures: associations between direct and observational measurements.

ObjectivesTo determine the effect of different levels of Galilean loupe magnification on working posture as measured by compliance with ergonomic posture positions, angular deviation from the neutral position of the neck, and muscle activation in the neck and upper back region during simulated clinical conditions.MethodsAn experimental laboratory study was performed in which the dependent variables were compliance with ergonomic posture requirements while performing simulated restorative procedures in Restorative Dentistry, angular deviation from the neutral position of the neck, and muscle activation in the neck and upper back. The independent variable was the level of Galilean loupe magnification, which was tested at four levels (naked eye, 2.5× magnification, 3.0× magnification, and 3.5× magnification). The cavity preparations and Class I composite resin restorations were performed on artificial first molars on a mannequin in a dental chair. The Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP) was used for the postural analysis; as was an analysis of the angular deviation from the neutral position of the neck and surface electromyography. Working posture was recorded on video over the course of the procedure. Participants were filmed from three different angles. The Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP) assessed compliance with ergonomic posture requirements. A locally produced posture assessment software analyzed angular deviation. Surface electromyography bilaterally assessed activation of the sternocleidomastoid, descending trapezius and ascending trapezius muscles. Two-factor analysis of variance (ANOVA) and either Tukey’s post-hoc test or the Games-Howell post-hoc test were performed (α = 0.05).ResultsDuring the cavity preparations and restorations, the use of Galilean loupes at all magnifications positively influenced working posture as measured by participants’ compliance with ergonomic posture positions (p < 0.01) and neck angulation (p < 0.01); the use of these loupes did not affect muscle activation in the regions evaluated (p > 0.05).ConclusionThe use of Galilean loupes had a positive effect on dental students’ working posture during the restoration procedures performed.

Comparison of Radiovisiography, an Apex Locator and an Integrated Endomotor-inbuilt Apex Locator in Primary Teeth Endometrics.

Aim and objectiveTo compare the accuracy of radiovisiography (RVG), Root ZX mini Apex locator, and Endo radar's inbuilt Apex Locator during working length determination determination in primary teeth with the actual/direct canal length.Materials and methods58 primary teeth indicated for extraction in children of age group 4-12 years were selected. RVG, Root ZX mini Apex Locator, and Endo radar's Apex Locator were used to determine the working length intraorally. Following extraction of the teeth, the actual working length was determined with magnifying loupes (2.5×) using a K-file and an endodontic ruler. The data was tabulated and statistically analyzed.Results84 canals (58 teeth) were evaluated and Root ZX mini Electronic Apex Locator (EAL) showed no statistically significant difference with the actual measurement (p = 0.18) whereas Endo radar and RVG showed statistically significant difference. Endo radar underestimated, while RVG overestimated the working length. The most accurate method for working length measurements of the root canals in primary teeth was Root ZX mini EAL, followed by Endo radar and the least accurate was RVG.ConclusionThe Root ZX mini Apex Locator showed the most promising results and had an excellent degree of agreement with actual working length, followed by Endo radar and RVG.How to cite this articleKhan SA, Khanna R, Navit S, et al. Comparison of Radiovisiography, an Apex Locator and an Integrated Endomotor-inbuilt Apex Locator in Primary Teeth Endometrics. Int J Clin Pediatr Dent. 2022;15(S-1):S18-S21.

Wrist Arthroscopy Using the 2R Portal: Is It Safer Than the 1,2 Portal?

The purpose of this study was to compare the 1,2 with a novel 2R portal in terms of proximity to critical structures. Wrist arthroscopy was performed on 8 fresh frozen cadavers via the 1,2 and 2R portals. External anatomy was then dissected under loupe magnification. The closest distance between the portals and surrounding anatomical structures was measured in millimeters using digital calipers. The 1,2 portal was significantly closer to radial artery and first extensor compartment tendons than the 2R portal. The radial artery was on average 1.32 mm from the 1-2 portal and 14.25 mm from the 2R portal. The 2R portal was significantly closer to the second and third extensor compartment tendons. The closest branch of the superficial branch of the radial nerve (SBRN) was on average 2.04 mm from the 1-2 portal and 7.59 mm from the 2R portal, but this was not statistically significant. We advocate using the 2R portal preferentially to the 1,2 portal when treating radial sided wrist pathology to decrease the risk of iatrogenic radial artery and SBRN injury.

Topography of the deep branch of the ulnar nerve between genders: a cadaveric study with potential clinical implications

The lack of meticulous knowledge concerning the topographical anatomy of the deep branch of the ulnar nerve (DUN) may pose difficulties, leading to a delay or a misdiagnosis of a DUN injury. Identification of the DUN is quite difficult without precise anatomical landmarks as reference points. The current study investigates the topography of the DUN between genders, taking as a reference point a well-known landmark, the Kaplan line, used in hand surgery for carpal tunnel release. Twenty-two (15 males and 7 female) fresh frozen adult cadaveric hands were dissected by using magnifying loupes (3.5 and 5.0 x). We marked values proximal to the Kaplan line as positive (+), while we marked distal ones as negative (-). The mean distance DUN–Kaplan line was 1.69 ± 4.45 mm. In male hands, the mean distance was 4.17 ± 1.88 mm, distal to the Kaplan line, while in females, the mean distance was −4.92 ± 0.69 mm proximal to the Kaplan line. Gender dimorphism was detected, with higher statistically significant values in male hands (p = 0.001). Cadaveric studies of the DUN topography, course, and distribution pattern are uncommon. The current study provides an accurate description of the DUN topography, taking the Kaplan line as a reference point, emphasizing gender differences. The DUN is located distally in males and proximally in females. Knowledge of these predictable anatomical relations may help hand surgeons intraoperatively when dealing with a DUN lesion, because of hand trauma or during the decompression of the DUN.

Magnification in Dental Ergonomics – A Comprehensive Review

Work related health hazard in dental professionals is increasing rapidly nowadays in all specialty of dentistry. Among various known disorders, musculoskeletal disorder is the most prevailing among dentists all over the world and more so in developing countries. Prolonged inappropriate postures can lead to cervical and spinal pain resulting in reduced efficiency of the clinician. Various guidelines and measurers have been introduced time to time to improve the working pattern but still it hasn’t been tackled appropriately. To overcome the problem of musculoskeletal disorder, fruitful application of ergonomics in the form of various magnifying loupes should be introduced aiming to reduce the illness and injury of muscles and increased satisfaction and better efficacy amongst dental clinicians.