The dental operating microscope (DOM) has rapidly become an everyday tool in every aspect of endodontics. Treatment that was once dictated by "feel", can now be visualized. The operating microscope aids in the location of hidden canals, negotiation of calcified canals, diagnosis and treatment of cracks/fractures, repair of iatrogenic damage, removal of separated instruments, post removal, removal of caries, documentation, patient education and in the placement of restorative materials. Every aspect of endodontics is improved with microscopy. Until you have seen a tooth through the microscope, you don't know what you are missing!
The follow cases show the show some of the many uses of the dental operating microscope in endodontics.
The microscope allows you to see the color differences between the pulpal ceiling, walls and floor. You also can distinguish between primary dentin and secondary dentin by the color. This aids in finding calcified canals.
The microscope will allow you to see minute amounts of dentinal debris which tend to stick to remnant pulpal tissue.
The microscope allows you to see the color difference between the pulpal floor and pulpal stones.
Notice the yellowish color of the reparative dentin (pulp stone) This color distinction can only be seen under the magnification and direct light of a microscope.

xray#1: PreOp radiograph of #14.
Previous RCT with inadequate obturation
and missed 4th canal.
xray#2: PostOp radiograph
see case study

3 MB canals / PostOp radiograph

#12 Calcified Canals / PostOp radiograph

Photo 1: #2 with occlusal amalgam. Cracks in the MMR & DMR noted
Photo 2: Crack can be seen along the pulpal floor connecting the mesial and distal – tooth is diagnosed as non-restorable

Photo 1: Perforation of the root during post placement
Photo 2: 6 month recall shows continued healing
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