Microscopic endodontics — is it worth paying extra for a microscope

How is root canal treatment different under a microscope from standard endodontic treatment?

Root canal treatment under a microscope differs from standard endodontic treatment primarily in the degree of precision and accuracy with which it can be performed. Here are some key differences:

• Increased Visibility — the dental microscope provides a much larger magnification and better illumination of the treatment area. Thanks to this, the dentist can accurately see the inside of the dental canals, which allows precise removal of all infected pulp and cleaning and shaping of the canals.
• Accuracy and precision — the use of a microscope allows accurate localization and treatment of all dental canals, including those that could be missed during standard treatment. Microscopes also make it possible to precisely locate and remove the remains of pulp or old materials filling the ducts, which can be a source of infection.
• Reducing the risk of complications — precise treatment under a microscope significantly reduces the risk of damage to tooth structures, which in turn reduces the risk of complications after treatment.
• Patient comfort — the use of a microscope can reduce the time of the procedure and reduce the patient's discomfort, because the doctor can quickly and effectively clean the dental canals.
• Better diagnosis Dental microscopes can help dentists detect cracks and other subtle problems that might go unnoticed during standard treatment.

These are just some of the benefits of using a microscope for root canal treatment. In practice, this method affects a significant increase in the standard of dental care and the effectiveness of endodontic treatment.

When is it necessary to treat teeth under a microscope?

Root canal treatment under a microscope may be necessary in many different situations. Although this technology can be used in almost any case of root canal treatment, it is especially useful in situations that require greater precision or where standard treatments may not be effective enough. Here are some of them:

• Difficult or complicated dental canals — Dental canals can have a complex arrangement, they can be tortuous, bifurcated, or very narrow. The microscope allows for accurate imaging and effective treatment of such channels.
• Failure of previous treatment If the previous root canal treatment did not produce the expected effects, or causes recurring problems, a microscope can help identify the causes of failure, such as uncleaned canals or pulp residues.
• Detection of cracks and fractures of the tooth — The microscope is an invaluable tool in the diagnosis of minor cracks or fractures of the tooth, which can lead to chronic problems and pain.
• Removal of broken endodontic tools Broken pieces of endodontic tools may hinder or prevent effective root canal treatment. The microscope allows for precise removal of such fragments.
• Perforation Retractions — in case of unintentional perforations (punctures) of the tooth wall, the microscope allows you to precisely identify and repair such a place.

Advantages of microscopic endodontics

Microscopic endodontics, or root canal treatment using a dental microscope, offers a number of significant advantages, both for the dentist and for the patient. Here are a few of them:

• The dental microscope provides much greater magnification and better illumination of the treatment area. Thanks to this, the dentist can more accurately see and assess the condition of the dental canals, which increases the effectiveness of the procedure.
• Thanks to a precise view of the inside of the tooth, the doctor can more thoroughly clean the canals, remove all the pulp and accurately fill the canals, which translates into better treatment results.
• Dental microscopes allow doctors to avoid damage to tooth structures that can lead to complications. For example, the doctor can more easily detect and avoid perforation of the dental canal.
• Root canal treatment under a microscope can be less painful and stressful for the patient. With a more accurate view of the tooth structure, the doctor can perform the procedure faster and more efficiently, which reduces discomfort and shortens recovery time.
• Microscopes can help dentists spot subtle cracks and other problems that might go unnoticed during standard treatment.
• Many dental microscopes allow the recording of the procedure in the form of a photograph or video, which can be a valuable educational tool and helpful in the patient's medical records.

Disadvantages of microscopic endodontics

Although there are many benefits to microscopic endodontics, there are several potential disadvantages that are important to consider:

• Dental microscopes are advanced devices that can be expensive to both purchase and maintain. This could mean that treatments using this technology could be more expensive for patients.
• Although microscopes can help reduce the time of some procedures by allowing the task to be performed precisely, they can also increase the time of other procedures because the dentist must fine-tune and focus the microscope.
• The use of a dental microscope requires additional training and practice. Not all dentists have experience using these devices, which may limit access to this form of treatment.
• Working with a microscope may require the dentist to maintain a certain posture for a long time, which can be uncomfortable and lead to back or neck problems.
• In some cases, especially in hard-to-reach areas of the oral cavity, the use of a microscope can be difficult.

However, it is important to emphasize that despite the disadvantages mentioned, the benefits of using a microscope in endodontics often outweigh. The higher cost and additional training requirements are usually offset by better treatment outcomes and patient satisfaction.

Treatment of teeth under a microscope — what does the procedure look like?

Root canal treatment under a microscope uses the same basic procedure as standard root canal treatment, but with the additional use of a dental microscope to better see the tooth structure and perform the procedure more accurately. Below I present the detailed steps of this process:

1. Preparation - before the procedure, the patient is given local anesthesia. The dentist then puts on a special cover, called a cofferdam, to isolate the tooth and keep the treatment area dry and clean.
2. Access to the canals of the tooth — the dentist creates a hole in the crown of the tooth to access the pulp. The microscope allows the doctor to precisely perform this part of the procedure, minimizing the risk of damage to the tooth.
3. Cleaning channels — using special endodontic tools, the dentist removes infected or dead pulp from the dental canals. The microscope provides a clear magnification, which allows you to thoroughly clean the channels, even the most tortuous and complex ones.
4. Flushing channels — channels are flushed with special fluids that help remove pulp residues and bacteria.
5. Filling channels — after cleaning, the channels are filled with a special material (most often gutta-perka), which ensures the sealing of the canal. The microscope allows for precise and accurate filling of the canal.
6. Tooth restoration — after filling the canals, the tooth is rebuilt with a filling or crown, depending on the degree of damage to the tooth.

How long does root canal treatment take under a microscope?

The duration of root canal treatment under a microscope can vary depending on a number of factors, including the complexity of the case, the number of dental canals to treat, their shape, and whether it is a first treatment or a re-endodontic procedure (re-root canal treatment).

Typically, root canal treatment under a microscope can last from 1 to 2 hours, but in some complicated cases it may require more than one visit. Keep in mind that although the procedure may take longer than standard root canal treatment, it is usually more effective and gives better results in the long run.

It is important to consult with your dentist or endodontist to get accurate information about the expected duration of treatment for your particular case.