Loupes and Lights – It’s all in the Detail
As restorative materials get smarter, endodontic instruments increase in accuracy and implant apparatus evolve, visualisation becomes even more important in the dental setting. Gone are the days of seeing a dentist wearing loupes and thinking it is because their eyes are failing them. Now magnification has become essential to ensure precision and, often over-looked, to help prevent poor posture and its consequences1. As long ago as In 1999, one survey found that 52% of endodontists had access to and used an operating microscope.2
Loupes and Lights
The human eye, when unaided, has the ability to distinguish two distinct lines that are separated by a minimum distance of 200 microns; in other words, when these lines are closer together than 200 microns, the eye will see these as a single line3. With just 2.5x magnification (such as with an entry level set of loupes) the level of detail becomes an incredible 80 microns.
Dental schools are leading the way by recommending their students use loupes that are 2.5x magnification or more. Studies have shown that even with that level of magnification, 50% fewer mistakes are made in tooth preparation. The journey then through the choice and levels of visualisation aids can bring excitement to treatment in a range of specialties.
There are various different types of loupes on the market, the main two are: Through the Lens (TTL), and Flip up Loupes. TTL loupes have the magnification built onto the lens, which means they cannot be moved, whereas Flip up loupes have a movable arm attached to the magnification and are adjustable. Both have their own advantages and disadvantages.
Illumination is an important aspect of loupes as the dentist’s head eclipses the overhead lamp. Therefore, most loupes come with, or can have added, a light source to ensure clarity in vision.
Since its inception in the 1950’s, the Dental Operating Microscope (DOM) has become a fundamental piece of kit within the dental surgery, catering for a range of clinical procedures and ensuring improved ergonomics. Further still, as the patient is becoming more and more involved in their dental treatment, it is a powerful tool and means of explanation and involvement; after all a picture is worth a thousand words!
It is often assumed that microscopes are for Endodontists only. It is true that the use of higher magnification on endodontic work does improve success: studies have shown that they can improve the ability to uncover more pulpal anatomy as compared to the use of little magnification or low power loupes4. However, other specialties of dentistry are now reaping the benefits of DOM. For example, in periodontics, many practitioners have found that routine usage of the DOM could provide for more delicate surgical procedures allowing improvements in postoperative pain and quicker healing5.
The DOM offers a true stereoscopic vision and can be mounted on a ceiling, wall or floor stand, but may also have a mobile base so it can be moved from room-to-room. They have multiple levels of magnification, typically from 2.1x to 19x power. The main advantages of a DOM are improvements in precision of treatment, better ergonomics, a means of documentation and patient involvement through live videos.
The experts in this field are undoubtedly Nuview offering product support and professional aftercare service. Nuview is the distributor of Carl Zeiss magnification equipment who has been operating for over a century, supplying a range of loupes, microscopes and accessories as well as training and support.
The EyeMag Pro loupes offer high levels of magnification (3.2x to 5x) ideal for those users needing to differentiate between minute structures. For comfort, there is a choice of carrier system and accessories to ensure you can look after your loupes for the long-term. Alternatively, if you are a first time user of loupes the EyeMag Smart loupes are lightweight to wear, intuitive-to-use and easy-to-operate.
The EyeMag Light 2 maximises the intensity of illumination ideal for when fine detail visualisation is required, or the Saphrio 2 Light can be altered to accommodate all head-worn loupes and magnifying glasses from Carl Zeiss
There can be no doubt that modern day dentistry would be impossible without the innovations and advances in visualization and magnification. The ability to see more and treat more has transformed the profession and means that patients now receive a far higher level of service and care than was ever possible before.
1. Chang BJ. Ergonomic benefits of surgical telescope systems: selection guidelines. J Calif Dent Assoc. 2002;30:161-169.
2. Mines P, Loushine RJ, West LA, et al. Use of the microscope in endodontics: a report based on a questionnaire. J Endod. 1999;25:755-758.
3. Carr GB. Magnification and illumination in endodontics. In: JF Hardin, ed. Clark’s Clinical Dentistry: 1998 Update. St. Louis, MO: Mosby-Year Book; 1998:1-14.
4. Schwarze T, Baethge C, Stecher T, et al. Identification of second canals in the mesiobuccal root of maxillary first and second molars using magnifying loupes or an operating microscope. Aust Endod J. 2002;28:57-60.
5. Shanelec DA, Tibbetts LS. A perspective on the future of periodontal microsurgery. Periodontol 2000. 1996;11:58-64.
6. Belcher JM. A perspective on periodontal microsurgery. Int J Periodontics Restorative Dent. 2001;21:191-196.