Students first learn to perform procedures with naked eye. As they transition into loupes, the magnification and illumination improve, however the field of view decreases. With loupes, there are limitations of fixed position and frequent calibration. Later, with the transition to microscope, the visibility improves further, and fine details are much more apparent. With the microscope, there is also a learning curve to optimize settings, learn how to move it and position if effectively. The feeling when first learning the microscope is akin to when first learning indirect vision. Later students enhance their visualization by using filters and fluorescence modalities.
The patient is a long-time patient of the College and presented with generalized large non-carious abfraction lesions. The patient was highly motivated to have the lesions restored to reduce the risk of fracture and to improve the esthetics of his smile.
The strategy was to be conservative while preparing the teeth to conserve the remaining tooth structure as it was already compromised. The size of the lesions necessitated extending the restoration interproximally, without breaking contacts, as well finish line placement slightly below the gingival margin.
"The use of the dental microscope increased the accuracy of my preparation margins and increased visibility of the interproximal areas. This resulted in less iatrogenic damage to adjacent teeth and tissues, as well as allowed for superior finishing of the composite with the integrated illumination."
The Before and After picture was posted on Facebook, and with the support and likes from students, followers emerged as the winner of the ZEISS before and after competition for dentists.
It is important for students to become familiar with the use of a variety of materials and equipment, including microscopes. Having access to a microscope is especially important for student endodontic procedures. When a student is presented with a difficult case that they are struggling to complete with just loupe magnifications. Being able to attempt the case under microscope magnification instead of referring the case out facilitates learning by the student and better prepares them for future practice.