Minimal intervention dentistry II: part 1. Contribution of the operating microscope to dentistry

Sitbon, Yves; Attathom, Tipapat; St-Georges, Annie J

doi:10.1038/sj.bdj.2014.48

Cited by 16 publications

(11 citation statements)

References 29 publications

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“…The findings of a 2-visit study (Hashem et al 2015) that used Carisolv gel for excavation of carious dentin without magnification showed that only 65.4% of teeth were deemed healthy using CBCT at M12. This finding is similar to the current control group (73.3%) but lower than the success rate in the experimental group (90%) in which operative microscopy was used, suggesting that the use of the operating microscope, increasing the visual capacity of the operator, may contribute to avoiding unnecessary tissue damage (Sitbon et al 2014). Therefore, at this stage of intervention, there remains scope for the operator to optimize a tissue environment conducive to pulp repair and healing.…”

Section: Discussionsupporting

confidence: 76%

Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial

et al. 2018

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A single-blind randomized controlled clinical trial in patients with deep caries and symptoms of reversible pulpitis compared outcomes from a self-limiting excavation protocol using chemomechanical Carisolv gel/operating microscope (self-limiting) versus selective removal to leathery dentin using rotary burs (control). This was followed by pulp protection with mineral trioxide aggregate (MTA) and restoration with glass ionomer cement and resin composite, all in a single visit. The pulp sensibility and periapical health of teeth were assessed after 12 mo, in addition to the differences in bacterial tissue concentration postexcavation. Apical radiolucencies were assessed using cone beam computed tomography/periapical radiographs (CBCT/PAs) taken at baseline 0 mo (M0) and 12 mo (M12). In total, 101 restorations in 86 patients were placed and paired subsurface, and deep (postexcavation) dentin samples were obtained. DNA was extracted and bacteria-specific 16S ribosomal RNA gene quantitative polymerase chain reaction was performed. No significant difference was found in bacterial copy numbers normalized to mass of dentin ("bacterial tissue concentration") between the self-limiting (96.3% reduction) and control protocols (97.1%, P = 0.33). The probability of 12-mo success was 4 times (odds ratio [OR] = 4.33; confidence interval [CI], 1.2-15.6; P = 0.025) higher in the self-limiting protocol compared to the control (conventional excavation technique), with pulp survival rates of 73.3% and 90%, respectively ( P = 0.049). Molars had a 4 times higher probability of success compared to premolars (OR, 4.17; CI, 1.17-14.9; P = 0.028), and symptom severity did not statistically predict outcome (OR, 0.41; CI, 0.12-13.9, P = 0.153). CBCT detected significantly more periapical (PA) lesions than PA radiographs at the baseline visit ( P < 0.001). In conclusion, the self-limiting caries excavation protocol under magnification increased pulp survival rate compared to rotary bur excavation ( ClinicalTrials.gov NCT03071588).

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Section: Discussionsupporting

confidence: 76%

Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial

et al. 2018

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“…Generally, the microscope is significantly more expensive than the loupe due to various optic designs that provide substantially higher levels of magnification without causing eye strain. [ 21 65 ] The heavy optics is, in turn, justifiably supported by hinges and arms that stay static in any position.…”

Section: Drawbacks Of Magnification Devicesmentioning

confidence: 99%

Magnification in endodontics: A review of its application and acceptance among dental practitioners

2018

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The application of magnification devices in endodontics is mainly meant for visual enhancement and improved ergonomics. This is crucial especially when long hours are spent in a narrow operating space to treat obscure microanatomy. Nevertheless, application of magnification in endodontics has yet to be introduced into the mainstream practice due to various influences in behavioral patterns. By conducting an extensive literature search in the PubMed database, this narrative review paper depicts the present state of magnification devices, their applications within the endodontic practice, factors that influence their usage, the advantages, and shortcomings, as well as the significances of magnification in the field of endodontics. This review paper will encourage clinicians to employ magnification in their practice for improved outcome.

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“…In dentistry, these values can be compromised even further by the low luminosity in the buccal cavity. 50 Devices of clinic microscopes and head-mounted loop, which equipped dentists with accurate views, are thus considered as visual basis. 51…”

Section: Consensus Statementmentioning

confidence: 99%

“…55–57 Comparatively, DOMs are more advanced in: (1) alternative scales with high-level magnifications; (2) better ergonomic posture; (3) coaxial illumination device equipped; (4) video recording system with high-performance cost ratio. 50,58,59…”

Section: Consensus Statementmentioning

confidence: 99%

Minimal invasive microscopic tooth preparation in esthetic restoration: a specialist consensus

Zhao

et al. 2019

Int J Oral Sci

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By removing a part of the structure, the tooth preparation provides restorative space, bonding surface, and finish line for various restorations on abutment. Preparation technique plays critical role in achieving the optimal result of tooth preparation. With successful application of microscope in endodontics for >30 years, there is a full expectation of microscopic dentistry. However, as relatively little progress has been made in the application of microscopic dentistry in prosthodontics, the following assumptions have been proposed: Is it suitable to choose the tooth preparation technique under the naked eye in the microscopic vision? Is there a more accurate preparation technology intended for the microscope? To obtain long-term stable therapeutic effects, is it much easier to achieve maximum tooth preservation and retinal protection and maintain periodontal tissue and oral function health under microscopic vision? Whether the microscopic prosthodontics is a gimmick or a breakthrough in obtaining an ideal tooth preparation should be resolved in microscopic tooth preparation. This article attempts to illustrate the concept, core elements, and indications of microscopic minimally invasive tooth preparation, physiological basis of dental pulp, periodontium and functions involved in tool preparation, position ergonomics and visual basis for dentists, comparison of tooth preparation by naked eyes and a microscope, and comparison of different designs of microscopic minimally invasive tooth preparation techniques. Furthermore, a clinical protocol for microscopic minimally invasive tooth preparation based on target restorative space guide plate has been put forward and new insights on the quantity and shape of microscopic minimally invasive tooth preparation has been provided.

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Minimal intervention dentistry II: part 1. Contribution of the operating microscope to dentistry

Cited by 16 publications

References 29 publications

Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial

Self-Limiting versus Conventional Caries Removal: A Randomized Clinical Trial

Magnification in endodontics: A review of its application and acceptance among dental practitioners

Minimal invasive microscopic tooth preparation in esthetic restoration: a specialist consensus

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