INTRODUCTION:-
The clinician’s ability and success in performing root canal treatments on their patients is being improved by the advancements in the development of dental equipment.1Recent advancement in surgical endodontics is ‘Microsurgical Endodontics’. Magnification helps the clinician not only to see more, but to see well. High levels of magnification increase the aggregate amount of visual information which helps the dentists for diagnosing and treatment of dental pathology.2Routine endodontic practice, confronts the dental practitioner with many challenges.3
In 1978 the concept of extreme magnification, in the form of an operating microscope improvements in visual acuity which was made possible through the use of the operating microscope, would be helpful in endodontic treatment.4The first commercially available Dental Operating Microscope (DOM) was introduced in 1981 by Chayes-Virginia Inc. It was named as Dentiscope. It was poorly configured and ergonomically difficult to use. 5
A magnifying loupe is a piece of equipment used in dentistry which increases the efficiency and quality of dental care. The use of magnifying loupe increases visual sharpness and also the accuracy of the endodontic procedure.1The use of magnifying louperesults in superior visualisation of the treatment field which improves diagnostic capability1,6and endodontic outcomes7. The use of a loupe also improves the dentist’s working posture and reduces the risk of developing repetitive-stress injuries due to poor body position.8
The magnifying loupe often enables the dentist to confirm the presence of cracks in tooth.9 The use of a loupe also increases the efficiency of operative procedures, specifically with regard to endodontic treatment.1,10,11.The pulp chamber and canals can be sclerosedparticularly in teeth with large caries. In case of calcified pulp chamber,dentist can find it difficult to locate the root canals.1Magnifying loupe may also help the clinician to identify the root canal entrance and locate probable extra canals.7 Hence, the use of a magnifying loupe in endodontic treatment improves clinical and radiographic outcomes.12
Despite the number of advantages of using a magnifying loupe in endodontic treatment, some dentists do not use one during endodontic treatment.1,6,8,11 Some of dentist believe that the use of a magnifying loupe increases theamount of time required to perform endodontic procedures.8,11
Therefore, this study was conducted to compare the time it took to perform endodontic treatment in primary teeth with or without the use of a magnifying loupe.
AIM
To compare treatment time for pediatric endodontic therapy with or without magnifying loops
INCLUSION CRITERIA
• Patients aged 6 to 9years of age.
• Presence of acute pain.
• Patients requiring single sitting endodontic therapy for primary molar.
• Clinically:Multi-rooted teeth with adequate coronal structure for proper isolation, temporization, and restoration and with pulp involvement
• Radiographically: Radiolucency involving enamel, dentin and pulp in multi-rooted teeth without furcation involvement and with teeth having at least 2/3 of root length
EXCLUSION CRITERIA
• Patients with systemic infection
• Patients with psychological problems
• Teeth with less than half of the coronal structure remaining.
• Teeth with more than 3 canals.
• Clinically : Teeth with abscess /cellulites /draining sinus and Non restorable teeth
• Radiographically: Teeth showing pathologic root resorption and Internal root resorption
Methodology
60 cases of deciduous molars were selected from the Out Patient Department of Pedodontics and Preventive Dentistry. They were categorized into two group’si.e30 patients with use of magnifying loupe and 30 patients without use of magnifying loupe.
ARMAMENTARIUM
• Diagnostic Instruments – Mouth mirror, probe, tweezers
• Gloves and mouth mask.
• 2ml Syringe
• Rubber dam kit
• Air rotor and Burs
• Endodontic files
• Local anaesthetic solution (with adrenaline)
• Saline
• Sodium hypochlorite
• Zinc Oxide eugenol
• Glass inomer cement.
CLINICAL PROCEDURE
A detailed case history was recorded for each patient. Complete clinical procedure was performed on 30 patients with use of magnifying loupe and 30 patients without use of magnifying loupe.
Local anesthesia was administered and the tooth to be treated was isolated under a rubber dam. The access opening was made using a round bur at high speed, deroofing was done and coronal pulp was removed. After locating the canals, extirpation of the pulp was done. Working length was determined and Biomechanical preparation was done using stainless steel H and K – files till size 35. Irrigation was done using normal saline.After final irrigation the canals were dried with absorbent paper points and obturated with zinc oxide eugenol. The coronal space was filled with GIC cement.
RESULTS
A total of 60 patients aged 6 to 9 were recruited. Independent variables evaluated to assess the difference in the transformed treatment time were patients’ gender, quadrant and the use of a magnifying loupe. It was noted that patients’ gender was not related to the treatment time. But treating younger patients (age 6 -7years) required more time than the elder patients. Treating upper molars required more time as compared to lower molars. Similarly less time required in treating patients using magnifying loups than without use of loups.
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