Microscopic Endodontics: what is it and what is it for?

Microscopic endodontics is the treatment in which, in addition to applying the latest technology in terms of instrumentation and obturation of root canals, it also uses magnification with an operating microscope. This technique, which was introduced in the late 90’s in endodontics, is used in other branches of medicine in microsurgery, such as surgical endodontics or apicoectomy, increasing in both cases the success of treatments significantly.

Microscopic endodontics improves vision and makes it possible to work more safely, in addition to performing complex procedures such as retreatments (re-do endodontics for persistent apical periodontitis in teeth that have already been treated and do not heal), teeth with anatomical difficulties, calcified canals, etc.

What does it consist of?

The application of magnification in spaces as small as the inside of a tooth, in addition to having a high quality and powerful coaxial light source in the microscope, allows specialists to visualize and explore the anatomy as never before in the clinic, since it allows them to see and work at the same time. The biggest problem with its use is the need for a complex training and learning curve for the professional, in addition, the vision inside the tooth is done indirectly with high quality mirrors and this entails more problems, since the vision is specular and when observing the object the hands are in a different plane to that of our eyes. For the practitioner this results in a more relaxed position, with the head upright and the back straight.

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In spite of the difficulties of handling during the first uses, the advances in microscopic endodontics assure us a more accurate diagnosis and, consequently, a more successful and better quality treatment.

Preparation for microscopic endodontics

It is the same as for conventional endodontics without magnification, although in practice when conventional radiology does not clarify the diagnosis of complex cases if a 3D CBCT radiology of high resolution and reduced field is performed, minimizing the patient’s exposure to X-rays. After the intervention, the professional will dictate a series of advice to be followed, just as he would do after a conventional endodontics, and in any case he will do so according to the circumstances and needs of the patient.

Alternatives to microscopic endodontics

Whenever endodontic treatment can be performed, whether through the crown of the tooth (orthograde treatment) or surgically or apicoectomy (retrograde treatment), it is possible to preserve the teeth, minimizing tissue damage and loss.

When a tooth is not treatable, then its extraction and the placement of an implant would be indicated, but the philosophy of modern dentistry is to delay as much as possible the extraction of the pieces, since they will naturally preserve the bone and soft tissues (gum), delaying in time the possible problems of implants such as peri-implantitis.