‘We can treat only what we can see'.
There is an immense difference between traditional Endodontic Surgery and Micro-Endo Surgery.
Microsurgical techniques made possible and accessible results, that were unimaginable before. Under microscopic control, the operative techniques reached continuous changes, allowing a better precision and quality standards.
The dramatic evolution from Endo-Surgery to Micro-Endo Surgery has enlarged the horizon of therapeutic options.
Illumination and magnification through the Microscope has fundamentally and radically changed the way endo surgery can be performed.
The introduction of the Microscope in Endodontic Surgery will give clinicians the necessary means to treat difficult cases with a higher degree of confidence and clinical success.
On one hand, the microscope enhanced the orthograde treatment as well as the retreatment, reducing the indications for surgery; on the other hand, we started to deal with ‘impossible’ cases, moving the borderline towards conservative surgical treatment. The only limitation is that this process requires more operative experience and pre-surgical planning for the inability to visualize anatomic landmarks and vital structures.
A clinical study by Pecora et al. in 1996, pointed out that ‘the endodontist now has an additional choice of treatment in cases where tooth extraction is inevitable.
The clinical experience has evidentiated the following benefits:
- Optimal hermetic seal of the neo-apex
- GTR application increases the long-term results in the treatment of borderline cases
- Correct and favorable management of endo-sinus pathologies
- Expanded diagnostic power in difficult clinical situations
- Excellent evaluation of clinical data to accelerate the correct choice in the determination between TOOTH or IMPLANT.
‘SEE BETTER…DO BETTER’.
Optical aids (loupes, microscopes, surgical headlamps, fiber optic handpiece lights, etc.) can improve resolution by many orders of magnitude. For example, a common operating microscope can raise the resolving limit from 0.2 mm to .006 mm (6 microns), which is a dramatic improvement.
Surgical operating microscopes have a steep learning curve, and mastering them requires training as well as patience and practice. Still, this piece of equipment and the learning effort it implies are well worth it, as cases that once seemed impossible can now be treated with a high degree of confidence and clinical success.