Do you know the hard surface of our teeth is meant to protect the roots of our teeth? Underneath our teeth enamel are miniscule passages called canals, which hold blood vessels and nerves. In endodontics we treat these sensitive tissues of the teeth also known as the pulp in case of inflammation and pain arising due to potential infection in the tooth’s pulp. This treatment is popularly known as Root Canal Therapy (RCT) often required when the tooth’s pulp gets infected. Usually this can happen due to injury to the teeth or an unnoticed dental decay and the procedure involves making a small opening on the affected tooth, cleaning and sterilising the infected tissue, sealing it with sterile biocompatible filler, and closing the tooth to avoid the possibility of re-infection.
Tooth preservation is the cornerstone of endodontic dentistry and endodontists will try give their best effort in trying to save a natural and this is where microscopic endodontics comes into real play. Traditionally an endodontist would take an x-ray of the problematic tooth to access the extent of infection in the dental pulp to chalk the treatment plan. This would then be followed by cleaning out of the infected tissue and canals with their expertise and years of treatment experience and then take another x-ray post the treatment to evaluate the treatment. The advent of 3-D imaging made it even more clearer for the endodontists to plan out the treatment, however microscopic endodontics has changed the game completely. Treatment outcomes have massively improved with microscopes and coupled with 3D imaginggiving patients greater comfort.
How does microscopic endodontics work?
Microscopic endodontics is a specialised area of dentistry that uses high-powered magnification to get a close-up view of teeth and other oral structures during treatment. The technology can be used for a variety of functions in surgery. Additionally, it is also useful during restorations including cavity treatments to ensure only the infected part of the tooth is removed, leaving more of the healthy tooth structure in place to preserve the strength and integrity of the tooth and avoid loss.
In dental medicine, the surgical microscope has become increasingly important for high-quality and successful surgeries, particularly in the field of endodontics. A microscope supports the dentist to conduct micro-invasive surgeries which aim to preserve the tooth substance, conserve the tissue, minimize the risks and reduce healing time.The biggest challenge faced by endodontist world is not failure in providing accurate treatment, that is something purely dependent on the technical skills and knowledge of the dentist which can be improved, but not having a detailed visualization of the surgical field does make treatment very difficult
.This is primarily because the outcome of an endodontic therapy is influenced by many factors that are not visible to the naked eye – e.g. additional root canals or anatomical variations – the high magnification and illumination provided by a dental microscope has become indispensable for both diagnosis and therapy. Today, it is widely agreed that the use of dental microscopes has helped to extend endodontic treatment potential.
A dental microscope can provide significant visualization benefits at all stages of endodontic treatment, from diagnosis and exposure of the access cavity to preparation, and from three-dimensional obturation to post endodontic management. High magnification, illumination of the surgical field can reveal fine details, helping the dentist to manage difficult cases with increased precision.Using a microscope, there’s so much more potential for tooth preservation which is the cornerstone of modern dentistry. And there is a large spectrum of medical treatment that can only be performed using a microscope, for example endodontic retreatment due to infections caused by side canals, insufficient root canal fillings or broken instrument parts.
With the development of new microsurgical instruments and the full-time use of a dental microscope, endodontic surgery has entered a microsurgical era. The surgeon can now visualize the entire bony crypt, lesion, and root tip securely and reliably. Microsurgical operating techniques tend to be more successful and less traumatic for patients. On the one hand, increased precision helps to preserve those teeth that would otherwise be lost. On the other hand, the dental microscope clearly reveals major obstacles for a successful restoration of the tooth, such as internal cracks extending down the canals, massive perforation, or inadequate coronal structure. The patient thus benefits from avoiding unneeded treatment, including pain and costs, if the tooth is not salvageable.
Dr Aamina Farook is specialist endodontist at Wassan Specialty Dental Centre; nwww.wassandental.com