The impact of dental operating microscopes on the success rates of endodontic treatments

Recent advancements in dental technology, such as magnification devices like loupes and surgical microscopes, have greatly improved the accuracy and quality of root canal treatments. Dental operating microscopes (DOMs) have become widely accepted in endodontics, providing enhanced visualization and facilitating precise identification of anatomical landmarks, root canal orifices, and pulp remnants. The increased magnification and illumination offered by DOMs have improved treatment outcomes by enabling more efficient removal of bacteria, debris, and obturation materials from the root canal system. Studies have shown that the use of DOMs can significantly increase the success rates of endodontic treatments, allowing for the identification and treatment of even the smallest canals and anatomical variations. Additionally, DOMs enhance ergonomics, patient communication, and documentation in dental practice. However, challenges such as cost and limited office space hinder their widespread use. Increased education and awareness of the benefits of operating microscope utilization are essential for its broader adoption in endodontic procedures.

An overview of dentin conditioning and its effect on bond strength

Given the inherent qualities of this medium, particularly when contrasted to enamel bonding, bonding to dentin is considered to be a less dependable approach. Further, when dentin is reduced, a sizable amount of cutting detritus coats the dentin's exterior, forming the smear layer. A steep decrease in interfacial adhesion over time has been attributed to the collagen web's inadequate resin impregnation as a result of the dentinal surface preparation with strong acidic agents like phosphoric acid, which left a zone of vulnerable collagen at the root of the hybrid smear layer. Self-etching priming agents that comprise acidic, non-cleansing, polymerizing monomers cause demineralization of the surface and encapsulate the collagen fibers and hydroxyapatite crystals while dissolving the smear layer or incorporating it into the adhesion interface. The concurrent occurrence of dentinal demineralization and monomeric penetration prevents collagen from buckling and shields an exposed collagen web. There may be a drawback to including the smear layer in the hybrid layer, according to certain investigations. Adhesion issues could arise even though the smear layer is reinforced with impregnated resin. To achieve dependable, robust resin-dentin connections, such defects may need to be removed by integrating a distinct etching process because they can reduce the resistance and longevity of the conjugated smear layer. In relation to a traditional bonding system, is has been discovered that removing the smear layer with 0.5 M ethylene diamine tetra-acetic acid (EDTA) before applying a self-etching primer result in greater bond strengths. Even though this approach integrates the smear layer within the adhesion interface, the pre-conditioning of dentin with just an acidic primer is highly convincing and merits additional exploration for the streamlined total-etching systems.