In vivo analysis of conservation of tooth structure using conventional method, loupes, and dental operating...

The aim of the study was to evaluate and compare the extent of tooth structure preservation, efficacy of canal orifice identification, and procedural time during access cavity preparation in primary molars indicated for pulpectomy using three different visualization techniques: the naked eye, surgical loupes, and the dental operating microscope (DOM).

Forty-five children aged 5-8 years who required pulpectomy and met the inclusion criteria (CTRI/2023/05/067642) were randomly assigned to three groups (n = 15 each) based on the visualization modality employed. Standardized access cavity preparations were performed under different magnifications. Postoperative images of the access cavities were obtained using a DOM and analyzed using ImageJ® software to quantify the conservation of the tooth structure. The number of canal orifices identified and the total treatment time were documented for each case. Statistical analyses were conducted using one way analysis of variance, Tukey's Honestly Significant Difference, and Chi square tests.

Access cavity preparations performed under DOM demonstrated significantly greater conservation of tooth structure (P = 0.002) and the highest canal orifice detection rate. However, procedures performed under surgical loupes required the least amount of time (mean: 352.7 seconds). Conventional visualization is associated with more substantial structural loss and lower diagnostic precision.

Magnification-assisted endodontics significantly improves the precision of access cavity preparation. While the DOM offers optimal dentin conservation and enhanced canal orifice detection, surgical loupes strike a balance between improved visualization and procedural efficiency. The integration of magnification tools in pediatric endodontics will surely enhance clinical outcomes, although practical considerations such as cost, training, and operator adaptability must be acknowledged.