ABSTRACT
RESUMEN: Esta revisión sobre magnificación en periodoncia presenta la evidencia disponible sobre el tema. Dentro de este trabajo se incluyen: principios y prestaciones de la magnificación, ventajas y desventajas de los diferentes sistemas, características de los instrumentos de microcirugía, ergonomía, trastornos músculo esqueletales, resultados clínicos, cicatrización, percepción de los pacientes y habilidades clínicas necesarias. El objetivo del trabajo fue comprender el funcionamiento de la magnificación, comparar la microcirugía (cirugía con magnificación) vs macro cirugía (cirugía sin magnificación) en función de la ergonomía, la cicatrización y los resultados clínicos. Comparar las ventajas y desventajas de las lupas vs microscopio y conocer las habilidades necesarias para su utilización. Se realizó una búsqueda bibliográfica manual, las bases consultadas fueron: PubMed, Biblioteca Cochrane, EMBASE, Scopus, Science Direct, SciELO. La búsqueda fue sin límites temporales o de idiomas. Se incluyeron investigaciones, revisiones bibliográficas y metaanálisis, también se realizó rastreo de citas. Se recabaron un total de 251 artículos de los cuales se seleccionaron 43 para la revisión. Los artículos fueron revisados por los autores y aceptados por consenso para su discusión. En conclusión trabajar con magnificación aporta ventajas en todos los aspectos estudiados en esta revisión y en la percepción de los pacientes. Si se comparan las lupas con el microscopio, éste ultimo es mejor en cuanto a ergonomía, iluminación, posibilidades de documentación y mayor aumento. Incorporar la magnificación requiere entrenamiento, esta revisión expone los fundamentos por los cuales dicho esfuerzo se traduce en beneficios mayores.
ABSTRACT: This review on magnification in periodontics presents the available evidence on the subject, comprising principles and benefits of magnification, advantages and disadvantages of different systems, characteristics of the instruments in microsurgery, ergonomics, musculoskeletal disorders, clinical results, healing, perception of patients and necessary clinical skills. Objective: to understand the operation of magnification, to compare microsurgery (surgery with magnification) vs macro surgery (surgery without magnification) based on ergonomics, healing, and clinical results. Compare the advantages and disadvantages of loupes vs microscope and know the skills necessary to use them. Material and Method: a manual bibliographic search was carried out, the databases consulted were: PubMed, Cochrane Library, EMBASE, Scopus, Science Direct, SciELO. The search was without time or language limits. Research, literature reviews, and meta-analysis were included, and citation tracking was also done. Results: a total of 251 articles were collected, of which 43 were selected for the review. The articles were reviewed by the authors and accepted by consensus for discussion. Conclusion: working with magnification provides advantages in all the aspects studied in this review and in the perception of the patients. If the magnifying glasses are compared with the microscope, the latter is better in terms of ergonomics, lighting, documentation possibilities and higher magnification. Incorporating magnification requires training, this review expound the justification for which such effort translates into greater benefits.
ABSTRACT
OBJECTIVE@#To assess the effects of loupes and microscope on the posture of prosthodontists when preparing the laminate veneer, and to assess the clinical value of loupes and microscope from the ergonomic aspects.@*METHODS@#Twenty young prosthodontists from Department of Prosthodontics, Peking University School and Hospital of Stomatology were recruited into this study, which was a prospective, single blind, self-control trials. The research hypothesis was concealed and the participants were deceived about the precise purpose of the study to counterbalance the lack of direct blinding. The prosthodontists prepared laminate veneers of open window type in the artificial dental model, under routine visual field (control group), 2.5× headwear loupes (loupes group), and 8× operating microscope (microscopic group) by turning. The participants were photographed from profile view and front view. Thereafter, the subjective assessment was performed by themselves using the visual analogue score (VAS). The expert assessment was performed by two professors using modified-dental operator posture assessment instrument on the basis of photographs of the profile view and front view.@*RESULTS@#The subjective assessment scores for the control group, loupes group and microscopic group were 4.55±1.96, 7.90±1.12, and 9.00±0.92, respectively. There was significant difference between the three groups' subjective scores (P < 0.05). The expert assessment scores for the control group, loupes group and microscopic group were 16.38±1.52, 15.15±1.30, and 13.60±0.88, respectively. There was significant difference between the three groups' expert assessment scores (P < 0.05). Specifically, the three groups' expert assessment scores were significantly different (P < 0.05) in trunk position (front to back) (1.33±0.41, 1.03±0.11, 1.00±0.00), head and neck position (front to back) (2.75±0.38, 2.13±0.36, 1.23±0.38), elbows level (1.38±0.43, 1.40±0.45, 1.13±0.22), and shoulders level (1.43±0.41, 1.23±0.34, 1.13±0.28). Thereinto, the microscopic group was better than loupes group in head and neck position (front to back) and elbows level (P < 0.05).@*CONCLUSION@#Loupes and microscope improve the posture of the prosthodontist when preparing the laminate veneer, in which the microscope is better than loupes. Therefore, the magnification devices have clinical value from the ergonomic aspects.
Subject(s)
Humans , Dentists , Ergonomics , Posture , Prospective Studies , Single-Blind MethodABSTRACT
An in-depth knowledge of the root canal anatomy is important for any successful root canal treatment; however, complexities exist within the root canal morphology. The maxillary first molar has variations in its root morphology and canal configurations. In literature, this variation is only observed in an estimated 1.12%-1.17%. One such case is described in this case report which provides the endodontic management of a left maxillary first molar with two palatal canals using loupes magnification.
ABSTRACT
Successful endodontic treatment involves a proper access cavity preparation, biomechanical principles, and three-dimensional obturation. Thus, the clinician should have a through knowledge of anatomy and morphology of the root canal system. Failure in root canal therapy may be due to inability in locating the canal and its proper debridement. The configuration and a number of root canals in the maxillary first molars have been discussed for more than half a century. Maxillary first molars commonly present with three roots and three canals, with a second mesiobuccal canal (MB2) and (MB3). The current case reports describe the presence of extra canals MB2 and MB3 in a maxillary first molar.
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BACKGROUND: Microsurgical techniques are considered standard procedures in reconstructive surgery. Although microsurgery by itself is defined as surgery aided by optical magnification, there are no guidelines for determining in which clinical situations a microscope or loupe should be used. Therefore, we conducted standardized experiments to objectively assess the impact of optical magnification in microsurgery. METHODS: Sixteen participants of microsurgical training courses had to complete 2 sets of experiments. Each set had to be performed with an unaided eye, surgical loupes, and a regular operating microscope. The first set of experiments included coaptation of a chicken femoral nerve, and the second set consisted of anastomosing porcine coronary arteries. Evaluation of the sutured nerves and vessels were performed by 2 experienced microsurgeons using an operating microscope. RESULTS: The 16 participants of the study completed all of the experiments. The nerve coaptation and vascular anastomoses exercises showed a direct relationship of error frequency and lower optical magnification, meaning that the highest number of microsurgical errors occurred with the unaided eye. For nerve coaptation, there was a strong relationship (P<0.05) between the number of mistakes and magnification, and this relationship was very strong (P<0.01) for vascular anastomoses. CONCLUSIONS: We were able to prove that microsurgical success is directly related to optical magnification. The human eye's ability to discriminate potentially important anatomical structures is limited, which might be detrimental for clinical results. Although not legally mandatory, surgeries such as reparative surgery after hand trauma should be conducted with magnifying devices for achieving optimal patient outcomes.