This article describes the clinical techniques of extracting teeth when using microscopes or highly magnifying loupes (6x–8x or greater magnification) combined with head-mounted or co-axial illumination. Microscope-level magnification facilitates identification and utilization of purchase points to use for luxating teeth with straight elevators. In addition, magnification facilitates distinguishing between the perimeters of tooth particles and the surrounding alveolar bone, and permits identification and removal of intra-socket alveolar bone that hinders tooth extraction. Magnification facilitates sectioning of roots along furcations and sectioning them such that the bur is oriented parallel to the long axis of the tooth. After extraction, Magnification provides visual information that aids in debridement of the extraction socket. In general, magnification improves a dentist’s ability to use information within the perimeter of the tooth socket, and also inside the tooth socket, to identify and remove obstructions to tooth extraction. This may reduce the need to lay a full thickness flap to improve visibility of tooth particles, or to remove buccal or lingual bone to enable tooth particle removal. This may result in more systematic, less traumatic extractions that leave a more structured extraction socket for healing.

Statement of problem: The coronally advanced flap combined with free connective tissue graft is a predictable method for achieving root coverage in buccal gingival recession. The only major disadvantage is requirement of a second surgical donor site. Purpose: This study evaluates the amount of root coverage obtained by the free rotated papilla autograft with coronally advanced flap (FRPA+CAF) using microsurgical aids in the treatment of shallow buccal recession. Materials and Methods: A total of 30 isolated recession sites (2.5 – 4 mm) in 24 patients were selected and treated with microsurgically performed free rotated papilla autograft with a coronally advanced flap (FRPA+CAF). Clinical parameters such as recession depth (RD), recession width (RW), probing depth (PD), clinical attachment level (CAL), width of keratinized gingival (WKG), and papilla height and width at the donor site were evaluated and compared at baseline, 3 months and 6 months. Results: The mean preoperative recession height was 2.87 ± 0.50 mm. The mean postoperative recession height at the 3^rd month was 0.13 ± 0.5 mm, whereas the mean recession height at the end of the study (6^th month) was 0.4 ± 0.81 mm. The mean recession height coverage at the end of the study was 84.79%. The root coverage was 100% in 24 out of 30 sites. There was a statistically significant difference in RW, CAL and WKG. Conclusion: Periodontal microsurgery using FRPA+CAF is an effective and stable method for root coverage in shallow localized gingival recession. Further studies are needed to evaluate its efficacy with respect to other conventional root coverage procedures.

This article attempts to describe the characteristics of the human horizontal supra-alveolar fiber apparatus based on multi-format film scanner observation. A biopsy of the tissues was obtained from the maxillary anterior tooth region of a 65-year-old male. The tissue specimen was cut horizontally across the root, 3 μm apart, and 57 specimen slides were prepared in total. These specimen slides were Van Gieson-stained for histological analysis. Each specimen slide was microscopically examined with a multi-format film scanner. The horizontal structure was described based on the classification of Schroeder and Page. The most apical section showed that the semicircular fibers contributed to the transseptal fibers in the interdental gingiva. In the 10th section, the number of transseptal fibers decreased and palatal semicircular fibers were seen extended. The 30th section revealed that circular fibers decussated the transseptal fibers. These results suggest that the multi-format film scanner appears to be useful in observing the horizontal structural differences in the supra-alveolar fiber apparatus of the maxillary anterior dentition.

Sodium hypochlorite (NaClO) is used for root canal cleaning to dissolve organic tissue. However, the detailed mechanisms of dissolution of organic tissue have not yet been clarified. The aim of this study was to examine the mechanisms. Gelatin gel was interacted with 0-5% NaClO for 1-60 minutes. Then, we investigated weight of the remaining gelatin gel, pH, free radicals using electron spin resonance, and the relationship between free radicals and the amount of dissolution.

  A high concentration of NaClO dissolved large amounts of gelatin gel. When the interaction was terminated, pH of NaClO had changed to neutral. The organic tissue is dissolved under alkali conditions. However, we thought that there might be another factor involved, because the gelatin gel was dissolved under neutral conditions. The weight was concluded to have been lost by the generation of DMPO-X-like and hydroxyl radicals. We also interacted (Pro-Pro-Gly)₁₀ and detected the changes in the structure using nuclear magnetic resonance. The triple helix structure was decreased and the random coil structure was increased by the hydrogen bond dissolution induced using NaClO.

  Our findings suggest that the free radicals generated from NaClO finally result in the decomposition of organic tissue, as evidenced by its loss of weight.

Microscopes were first used for endodontic therapy in the 1990’s. Nowadays, many dentists use microscopes for diagnosis and treatment in Japan. However, there is limited information on how they can be used for education. In 2008, we reported the application of microscopic dentistry for education and treatment in endodontics at dental schools in Japan. At that time, microscope-aided education and treatment were not popular in Japan. In 2012, the Japan Association of Microscopic Dentistry (JAMD) sent the same questionnaire (seventeenth questionnaire) to 29 dental schools. Response to the questionnaire indicated that microscopic endodontic therapy and education in Japan had further improved in 2012 than 2008.