Background: Modern developments in microscopic endodontics have included Dental Operating Microscope (DOM), ultrasonics, piezo technology, CBCT, digital imaging and scanning, laser endodontics, and nanotechnology. Aim: This narrative review also assesses the diagnostic efficiency, treatment outcomes, patients’ outcomes and cost-effectiveness of these technologies. Methods: The literature search was done in PubMed, MEDLINE, Scopus, Web of Science, and Cochrane library by searching for English language, peer-reviewed articles published in the last 15 years. Results: According to this review, DOMs and CBCT both considerably increase diagnostic accuracy and therapeutic potential, which enhances treatment outcomes and raises patients' quality of life. Ultrasonics and laser endodontics can be used to produce minimally invasive treatments, and there is little to no pain following surgery. Nanotechnology and digital imaging are two instances of new technologies that still need to be developed. These technologies need significant capital investments from an economic perspective, but the investment pays for itself in returns. Conclusion: This review established that improvements in microscopic endodontic are impressive in diagnostic and therapeutic result while the initial costs are high. Arguments including increased accuracy in treatment, decreased patient discomfort, and better therapeutic outcomes serve as strong arguments for the continued application and advancement of endodontic tactics.
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