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Operating microscopes are playing an increasingly important role in the diagnosis and treatment of dental and pulp diseases. For surgical or non-surgical treatment, the use of oral operating microscopes has improved the success rate of dental treatment. However, in clinical practice, the treatment efficiency is often reduced because the doctors fail to grasp the key points of the microscope. Therefore, master the use of microscope operation skills, such as correct adjustment of oral surgical microscopes, reasonable adjustment of the positions of doctors, nurses, and patients according to different treatment teeth, familiarity with the use of micros Treatment has important clinical significance.
SOCO operating microscope adjustment steps
Preparation steps before operation:
Before the start of treatment, all the knobs of the oral operating microscope and all parts of the comprehensive treatment table that are easily contaminated or potentially contaminated should be isolated and protected, and the position of the operator’s chair and the patient’s position should be adjusted.
Before turning on the power of the SOCO operating microscope, make sure that the operating microscope’s LED light is off, otherwise it may irritate the patient’s eyes. You should also make sure that the magnification converter is at 3.2x scale before starting debugging. The binocular tube moderate adjustment knob scale returns to “0”, adjust the position of the swing arm and the objective lens to ensure that the observation object is in the center of the field of view, and the height of the objective lens is 25 cm from the observation object. Fix the microscope casters.
Operating position of SOCO SCM600 microscope
Keep the main body line of the microscope and the ground at an angle of 80-95, the mouth mirror and the main line at an angle of about 45, and the binoculars at an angle of about 165-185 with the ground. The best viewing angle is achieved through reflection. When treating the upper teeth, the plane of the mouth mirror is about 40 angles to the ground, and when treating the lower teeth, the plane of the mouth mirror is about 120 angles to the ground.
Check the proper position and angle of the maxillary dental arch
Check the proper position and angle of the mandibular dental arch
Doctor’s position
During the treatment under the microscope, doctors maintaining the correct posture and sitting posture can greatly reduce the damage to the cervical spine and spine caused by sitting for a long time. Microscopic root canal treatment and dental restoration treatment under the microscope, the doctor’s position requirements are basically the same, while micro-apical surgery has higher requirements for the operating field of view and viewing angle, and there are certain differences in the requirements for the doctor’s position. This difference is mainly reflected in the relative position of the doctor to the patient.
The doctor sits on the chair and should have a balanced and comfortable operating position, and should not change his posture by accommodating the microscope: ①The soles of the feet are flat on the ground ②The legs are parallel and separated ③The lower edge of the thighs and shoulders are parallel to the ground ④Head and neck , The back is in a natural upright position. ⑤Forearms are placed flat on the elbow rest. ⑥ Keep the shoulders and arms in a relaxed state, and cooperate with the wrists and fingers to complete fine operations. The range of the doctor’s activities should be maintained at 10 o’clock to 2 o’clock in the clock code, and appropriate adjustments should be made according to different tooth positions. When dealing with different tooth positions, the doctor’s corresponding working position is described later, but in actual work, the doctor should choose the appropriate working position according to personal habits and the specific situation of the tooth.
The above picture shows the recommended positions of doctors, nurses and patients during microscopic root canal treatment of lower anterior teeth (pictures are demonstrations of positions, and rubber dams are recommended in actual treatment)
The above picture shows the recommended positions of doctors, nurses and patients during microscopic root canal treatment of the upper right tooth (pictures are demonstrations of positions, and rubber dams are recommended in actual treatment)
Nurse’s position
Nurses should place equipment and drugs reasonably centered on the doctor, and deliver the required equipment and items in accordance with the standard parallel delivery method during operation to ensure that the doctor operates in a clear vision and a sufficiently spacious approach. The nurse’s chair position should be at 2 o’clock ~ 4 o’clock, on the left side of the patient, facing the doctor, about 10cm above the top of the doctor’s head, and about 4cm above the doctor’s eye level. Place your feet on the seat chassis, hips flush with the patient’s shoulders, and thighs parallel to the ground. The line between the shoulders is parallel to the line between the patient’s left ear and left shoulder, and is approximately 45 angles to the patient’s body. The nurse should be as close as possible to the delivery area. When operating in the patient’s mouth, the upper body posture is parallel to the surgeon and slightly rotated to the left. Depending on the content of the treatment and the position of the teeth, the nurse’s position needs to be adjusted accordingly.
Patient’s position
The patient takes the semi-recumbent or supine position. The positioning, cleaning and shaping of the root canal under the microscope requires a good field of view. Due to the limitation of the angle of the operation area, it is difficult for the surgeon to operate under direct vision. Therefore, the patient’s head position needs to be adjusted so that the oral mirror and the objective lens form an angle of about 45° , With the help of the mouth mirror to provide a clear and undistorted reflection image, the internal structure of the root canal can be seen clearly without moving the microscope and only changing the angle of the mouth lens during operation, and the best viewing angle can be achieved through the reflection of the mouth mirror. The patient’s posture should be adjusted according to different operating areas. The head turns to the non-working side. If the working side is the right side, the patient’s head turns to the left; if the working side is the left side, the patient’s head turns to the right. Due to the long operation time, the patient’s body can be adjusted to keep it in line with the head’s rotation, and the patient’s comfort during treatment can be enhanced.
The references for this article are taken from:
“Dental disease diagnosis and treatment standard dental operating microscope expert consensus” Author: Chinese Stomatological Association Professional Committee endodontic tooth
“Microscopic endodontic treatment study” Author: LING Jun-qi
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