Microscopes in endodontics

Need for Microscopes in Endodontics?

Light+Magnification=Perfection

Parts of the surgical Microscope

1         .     Base mounting and Body

    2.            Those focusing on the part of the oral cavity

                                I) Mounting systems

3. Those focusing on the operating site

                                 i)Binocular tubes

                                 ii)Eye piece

                                iii)Objective lens

                                iv)Illumination systems

4. Those that aid in fine focusing the part of the operating microscope.

                                i) Magnification changer

5. Microscope accessories

                                i) Beam Splitter

                                ii) Photo adapter

                              iii) 35mm still camera

                              iv) Television camera

                                             v) Video camera

                              vi)  monocular/binocular viewing tube    

                

Contents of guthkha

In case of Gutkha and other readymade packets named  gutkha are the major cause of oral caner  . Gutkha is originated in mid 70's . First impression  of gutkha  on people mind is that it is better alternative to tobacco . But iit is more hazardous than tobacco.It is mainly composed of betal nut. Over the packet contents are written like saffron , permited spices and other colring and flavouring agents added in it.What exactly permitted spices contains that we will see in detail in next post.

Re rootcanal treatment with central incisor having draining sinus

Re rootcanal treatment with central incisor having draining sinus

Patient  reported with this type of radiographic view and draining sinus with same tooth with pocket oin facial side. We have decided to undergo repeat root canal with this tooth.
This is RVG showing total length of the tooth .
RVG showing master cone with same tooth which is over extended approx. 2.5 mm. SO we cut it short for the exact sung fit.
Final RVG immediately after obturation and patient is under examination for two weeks.

Root canal treatment with curved canal is challenging but no immpossible.

Root Canal Treatment with curved canal takes time for biomecahnical  preparation , master cone selection and obturation also .Here is post obturation RVG with upper right second premolar.

RERCT

Re rootcanal treatment with open apex central incisor

Patient  reported with this type of radiographic view  and draining sinus with same tooth.
This is RVG showing total length of the tooth with open apex.
RVG showing master cone with same tooth.
Final RVG immediately after obturation.

 

Traditional treatments for gutkha and pan stain removal

To get rid of Gutkha and pan stain , traditionally in rural areas many people use locally available powder to remove which rubbed over the tooth surface to get rid of stains. But rubbing such powder over the teeth causes roughness to teeth. It will causes more staining if habit of gutkha and pan satining is no prohibited. So Its not a good option to remove stain.
Otherwise in some areas salt and alum   is used to remove stains.
Typical gutkha stains are seen over the cervical margin of all teeth and occlusallt and incisally these teeth are abraded . In such case where dentin is exposed due to attrision with habit of gutkha and pan eating , staining is not able to remove by scaling because it is totally embeded inside the dentin .

Postobturation RVGs of few patients

Today's case

This is a postobturation rvg with upper left first molar. Clearnace over the occlusal level is less. Today's case

Gutkha and pan staining

We are seriously working on gutkha and pan staining because it is very commonly seen in india becasue tobacco chewing , gutkha eating and paan chewing are the habits predominantly ssen in males . Various surveys proved that staining seen in gutkha eaters and pann chewers are extrinsic but constant contact of gutkha and pan in the mouth causes reddish color to gingiva , mucosa and most important to teeth also . In such cases  gingiva and muocsa look dry , shiny  , stretched .

This type of staining is extrinsic that means acquired from external soursces but long term use of it causes stain  to embed into craks ,fissures of teeth which very difficult to remove just by scaling . As long term use of cholrhexidine casues intrinsic stain which is not able to remove by scaling .So to remove gutkha staining otherwise alternative modalities should be used  that we will discuss it later. 

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