The Surgical Operating Microscope (SOM) is a sophisticated medical device, which provides outstanding visibility via a combination of magnification and intense illumination. For many years, the SOM has been used for the most intricate procedures in ophthalmology, neurosurgery, and other medical specialties. Its potential in the field of endodontics was not recognized, however, until the early nineties, at which time it was promoted for use in surgical procedures. Within a short period of time it became evident that enhanced visualization would greatly benefit even the most routine endodontic procedures. Today, it enables us to deliver an unprecedented level of care to our patients.
Why Is The Surgical Operating Microscope Of Particular Importance In The Field Of Endodontics?
The root canals, which we treat during endodontic therapy, are very small, delicate structures, found within the inner recesses of teeth, where visibility is rather poor. Visibility can be further compromised when root canal treatment must be performed through the confines of existing crowns or fillings. Furthermore, canals become progressively smaller, and more difficult to locate, due to calcification which occurs naturally with aging or from chronic inflammation. Previously, fiber optic illumination and magnifying loops were helpful in providing some measure of visibility, but it was not until the advent of the SOM that we were able to achieve true control over this obscure area.
How Does The Patient Benefit?
With the SOM we can safely explore the deepest recesses of the root canal system, ensuring the complete removal of all nerve tissue, with minimal sacrifice of sound tooth structure. As a result, post-operative discomfort is minimized, and the chances for a successful outcome are greatly enhanced. Furthermore, the SOM gives us the ability to perform a number of highly sophisticated procedures, which allow us to save teeth that would previously have been lost. Some of these procedures can be performed from within the tooth, while others are surgical in nature. In either case, saving a single strategic tooth can often make a difference to a patient in terms of the final prosthetic outcome.
The SOM has revolutionized the field of endodontics. We now work with smaller instruments, through smaller openings, and yet, are more thorough than ever before. As a result, the remaining tooth structure is stronger, the results are more predictable, and patients are more comfortable. When previously treated root canals become infected we can often manage to successfully retreat them non-surgically without disturbing existing crowns or bridges. When surgical procedures are necessary, microsurgery with the SOM allows us to minimize trauma to the soft tissues as we remove less healthy bone and root structure in order to expose the operative site. We are then able to visualize clearly the cause of the problem and treat it accordingly. Studies have confirm that surgical endodontic procedures performed with the SOM have a much greater rate of success and incur less post-operative discomfort than those performed without it.