Toothnerd18: Do you do most of your direct restorative with a scope or loupes?
Yes I use loupes a lot in daily practice. Check-ups min x5 mag and everything else x7.5 and above. I tend to lean towards loupes if opening/patient positioning is trickier or have to be super quick. If I’m prepping a whole arch I will lean towards loupes for the initial and then switch scope for margin finalisation. FYI I digital scan without loupes – but like the idea of Epson scanning glasses (a lot of people have bad posture when scanning).
Scope: endo/crack/fracture assessment/fine documentation and video. Marginal crown fit and cement excess checking. Fine layering. Sub gingival preps, placing posts, micro access or key hole surgery, Polishing cervical composite veneer margins. Max 1-2 teeth at a time… tend to flick between mags to realign my perspectives.
SCOPE PROS: The gold standard in vision. Great video. Better posture but need a chair with good support/arms like bambach. Integrated polarised and UV blue filters.
CONS: cost, space consuming/immobile, learning curves – time consuming, requires excellent assistant, chair and procedure ergonomics can be tricky. Can be draining on eyes and muscles still especially as fixed positioning.
Endo.doc: Criteria for loupe selection? How to find an ideal one? Better to upgrade from loupe to scope or directly to a scope?
Main criteria for loupe selection… i) what do you need it for ii) budget. Firstly it may be worth asking other dentists you know for their experiences. It sometimes helps visiting shows to try a few different brands to compare the weights. A heavy loupe with poor lenses creates a lot of strain and headaches.
I had 2.5,4.5,6.5,7.5 then scope. If you can afford a microscope I would always advise this. Almost everyone I know that uses microscope also has a pair of loupes. I personally use x7.5 mag and scope both consistently.
Vmath101: Hi doc. I am looking to buy some new loupes, I now use 2X magnification, I am a general dentist, what brand loupes would you recommend and what magnification, thank you
Fatma.al.bayati: For beginners .. or someone who’s newly intending to start using loupes in their work .. which magnification do you recommend we get to cover everything from restorative to endo work ..?
Berdnikneza: What is the magnification on loupes you feel is the best for a general dentist? (when scope is not possible yet)
I believe every general restorative dentist should be on at least 4.5/5x mag. There are many brands available just pic the lightest ones with the best mag I would strongly recommend you look @bryantdental.
Dimittrov_dd: What loops/magnification do you recommend for a beginner or there's no matter if i am beginner or not for the use of loupes?
If you can go straight to x5 mag I would recommend this but some people need to slowly adjust to this and start at lower mags.
Sairakhan14: How long does it take for a newbie to get accustomed to loupes? (3.5x) Asking from an exam point of view. Would you recommend using them in the exam? Thank you in advance!
All procedures including exams I would advise x5 mag and generally it can take upto 3 months until you full comfortable with your new level of magnification.
Chawlashravan: I have been torn internally weather to make the plunge and invest in a very High end loupes 5.5X / 7.5X or just jump to microscope directly. Currently on 3.5X. I feel the cost vs benefit vs learning curve is what scares me. For me a microscope is the epitome of dentistry but just scared if I will do justice. Your thoughts.
Once again it depends on what procedures you are doing. 3.5 to 7.5 is a big jump I normally recommend around x5 mag and see how you feel from there. Investing in yourself and your career is the most profitable and rewarding things one can do.
Arahmangh: Cj scopes vs zeiss, which one is better and what are their prices?
A good scope normally starts around £15-20K plus you need to make sure you add the price for a dedicated camera . A CJ currently is better value than a PICO but a Zeiss Extaro 300 is technically better than the current available CJ (although a new version is coming shortly) but its upwards of 30-40K so technically out of most peoples budgets. I have used many other scope brands also such as Labomed, Zumax, Leica etc all have their advantages and disadvantages but you can also look into second hand microscopes if you do not have that money available.
Kltay03: Does preparation under microscope increase preparation time significantly?
Working under scope does increase preparation time especially initially. As you see more errors and therefore want to correct them. Also your assistants are critical in improving your speed and work flow, you must not only train yourself but your staff.
Fedekamp: How can you mantain parallelism prepping under microscope?
Sometimes you have to flick back a mag to get a better overall view to make sure your orientation is kept. My assistant say I always orientate myself first before I start each time. You can also mark parallel lines on teeth as a guide.
Elimojam: How long does it take to get used to microscopes?
Everyone is different some people are natural and only need a few days while others will need months. Even today I still think I can always keep improving my workflow.
_ddiana: Do you prep while having the rubberdam on or do you only use it during cementation?
In general I always prefer to prep under dam or split dam. It makes the appointment far easier for the patient, my assistant and myself. With dam in place I always feel more relaxed. If I am bonding an emax it is almost always done under rubberdam.
Andreebrian: I have problem with my neck. I have herniated disc on C6-C7. I practiced under loupes but still have to nod a bit. Do you have any recommendation for loupes that can maintain my posture to be straight? or I still have to buy microscope? Is microscope can be used to my daily practice? thank you🙏🏻
You can get loupes that can help with this issue but any long procedure under scope or loupes will create compression of the spine. From others that have back issues they always prefer scope and try to integrate it as much as possible to their daily practice. Sometimes its worth having a wall mirror to make sure you are keeping the right posture.
Parklandsdentalpractice: I have the cj Optik as well, have you had any luck in getting good pictures from it? Ive tried off camera flashes with mixed results. Do you use flashes with it or not bother? (MICROSCOPE PHOTOGRAPHY)
You can get special twin flash microscope bracket for taking better pictures but in my experience a dedicated camera always produces better images but it depends on the images you want. Currently I will do my before and after images with a separate dedicated camera and not scope.
Drs.erikjan: I do all restoratives under microscope, but I struggle with perio and surgery, what do you think?
It can be done under scope quite easily if anterior (ref to hurzeler and zuhr). You need generally 2 assistants to help and micro surgical approaches are the way forward in my opinion. Sometimes stepping back in mag helps. In reality if Im taking out teeth I tend to use loupes as its far easier for positioning and applying safe pressure. Also if I am grafting or taking out multiple teeth I find loupes far quicker as I don’t have to keep adjusting the scope position. If you want to take your microscope surgery to the next left you need to create a custom surgical suite with an operating table not a dental chair so that you can rotate the patient to have direct vision.
Saurezaehne: What are the ingredients for a good picture under the scope?
Go to the highest mag get it in focus and step back the mag. Make sure you have enough light. Use a remote shutter to prevent movement. Get a very good mirrorless camera like the Sony. Sometimes photo stacking will create amazing images and many new cameras have this in built.