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First Steps into Hi-Res Dentistry - Dr. James Shorrock BDS

Dr. James Shorrock BDS runs a successful, 4-surgery private practice in Spalding, Lincolnshire. After working with loupes for years and finding them indispensable he invested in a Carl Zeiss OPMI Pico Dental Microscope.  (The following is an extract from the unsolicited testimonial he provided to Nuview, the full version is published on their website)

Whilst attending an endodontic course a fellow delegate enthusing about microscopes inspired me to investigate the use of a dental microscope myself. After much research I concluded that the Carl Zeiss OPMI Pico Dental offered the optimum ergonomics, durability and performance for my busy practice. This system features a MORAswing mechanism to allow effortless scanning across the mouth at the touch of a finger, and a ‘varioscope’ focusing system that hugely facilitates patient positioning and considerably improves depth of field.

I met Steve Clapman of Nuview, the exclusive UK distributor of Carl Zeiss visualisation systems, at a professional event and he agreed to visit my practice and discuss my requirements. His knowledge and professionalism led me through the options, and I was impressed by his honesty, guiding me away from certain expensive features as they would be unlikely to deliver value for money in my specific circumstances. 

All Carl Zeiss Dental Microscopes are custom built, and pending delivery Nuview invited me to attend the annual 2-day symposium, held in London. As well as international speakers, there were hands-on sessions involving demonstrations of microsurgical techniques and many experts in the field to answer questions.

Steve eventually delivered the microscope and spent several hours instructing me on setup, correct posture and showing me the controls. These were very intuitive, and I was excited to get going. I was determined to fully exploit my investment and not just use it for the occasional tricky endo or crown preparation. I started with checkups the following morning.

Looking ‘forward’ and working ‘down’ was a little alien at first, but the advantages were immediately obvious. Even with only a 4-6x magnification the excellent axial illumination and perfect optics showed the slightest differences in enamel translucency, early subsurface demineralisation and even interproximal caries, while filling defects, failing crown margins and fine cracks literally jump out at you.

The perio probe graduations are easily readable, soft tissue variations are instantly evident and anything of interest can be quickly snapped with the attached SLR, to be shown to the patient, filed for later reference, or printed to accompany a referral.   

The improvement in my posture and comfort was immediate and noticeable, although I would personally recommend the addition of a Support Stool with separate articulated armrests from BQE; 9-10 hour days now cease to be a problem!

After 2-3 days we began simple treatments, descaling and fissure sealing etc, using the microscope at around 4x so generally the whole mouth is visible as with medium powered loupes. Instrument location can initially be difficult, but I found that a sweep in of the hands close under the scope before dropping down into the mouth works well.  It took a week to develop the confidence to use a handpiece under scoped vision, but the advantages were instantly evident. You can see exactly what you are doing.

Using 6-10x magnification, the mind quickly focuses on the task in hand, you soon forget about the decreased field size. Every procedure is enhanced; for example, the very apparent fine differences in shade & translucency reduce the need to double check with a probe whether dentine is sound or carious. Damage to adjacent teeth is easily avoided as the marginal ridge appears like a cliff face next to your class 2 preparation, and a further advantage is the easy visualisation of any incipient defects in the adjacent teeth. Regularly using the scope for full crown preparations took around 2-3 months, but after completing half a dozen you soon miss10-16x magnification!   As a simple reference, at 4x you can see the whole mouth, 6x a quadrant, 10x 2-3teeth, 16x a single tooth, 20x a single canal orifice. 

Dental microscopes have traditionally been associated with endodontic procedures, and I now understand why. Pursuing my own interest in endodontics, I always strived to find the MB2 in upper molars and was probably successful using loupes about 20-30% of the time, but with the microscope this leapt immediately to more often than not.  It’s hard to overstate the difference good lighting and higher magnification make to both pre-treatment diagnosis and the potential quality of the actual outcome. Since acquiring the microscope I revisited several previous problem cases, using 16x magnification, it’s been possible to identify and remedy causes that had remained hidden even after apparently flawless x-rays and repeated attempts at correction. I have heard said on several courses – if you can see it you can do it, with a scope you can see and do a whole lot more.

After 4 months I use my microscope 75% of the time, although obviously there are occasions when the ‘macro’ picture is more relevant.  Although initially learning to work with the scope somewhat slowed me down, I am now back up to 95% of my original throughput and am confident that the overall quality of my work is considerably higher. It has been possible to undertake more complex procedures with confidence without the need to invest in additional instruments or attend lots of additional specialist courses.

In spite of the capital cost, I can heartily recommend the investment as a sound career move to any dentist who takes pride in their work, likes to be comfortable during their working day and puts quality patient care first.

I would be happy to discuss how to integrate a microscope into your daily practice and am easily contactable at This email address is being protected from spambots. You need JavaScript enabled to view it.

 

For more information please call Nuview on 01453 872266,

email This email address is being protected from spambots. You need JavaScript enabled to view it. or visit www.nuview.co

 

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