Magnification in general is considered one of the great revolutions in science, and specifically in dentistry. This revolution allowed scientists to undertake precise studies in the natural world and accelerate progress in the fields of medicine and dentistry.
The idea of enhanced magnification was introduced to dentistry in the form of an operating microscope in the late 1970s. The Dental Operating Microscope (DOM) was introduced to endodontics in the late 1980s by Dr. Gary Carr. He established that magnification and illumination could be helpful in increasing the success rate of endodontic apical surgeries [1]. Regular use of a DOM in various dental specialties was advocated for caries diagnosis and excavation [2], crown margins and post placement [3], surgical incisions, bone and soft tissue grafting procedures [4], and furcation and perforation repairs [2].
Despite the significant cost and relatively prolonged learning curve when starting using magnification tools in the different dental specialties, it is generally, believed that their use should be advocated. They are becoming an integral part of the era of modern microsurgery in various fields of dentistry. Advantages include improving the quality of treatment, achieving better posture during dental practice, reducing visual stress, and decreasing musculoskeletal injury when implementing them in our dental practices. These advantages occur only after going through the proper training and after gaining the required skills [5–9].
The clear advantage of using a DOM in dentistry, resulted in the Commission on Dental Accreditation requiring training in microscopy in all Advanced Endodontic Programs, as of 01 July 1997 [10]. In 2012, the American Association of Endodontics (AAE) stated that endodontics could benefit from the use of a DOM in the following procedures: detecting hidden canals, especially the MB2 canal in maxillary molars, retreatment cases where removing materials such as obturation materials and posts in necessary, removing broken instruments, achieving proper conservative access through superior visualization of the pulp chamber and canal orifices, perforation repairs, and all steps of endodontic surgery [11].
A study conducted by Buhrley et al. in 2002 [12], concluded that using a microscope or at least dental loupes is essential in locating the second mesiobuccal canal (MB2). Thus, the frequency of detecting MB2 for the microscope, dental loupes, and no magnification groups was 71.1, 62.5, and 17.2 %, respectively. This shows that the accuracy while using magnification to detect MB2 is about three fold more than the non-magnification group. This also emphasizes the importance of using magnification for locating the MB2 canals during endodontic treatment in order to provide better treatment outcome [12].
Tsesis et al. in 2006 [13] found that modern surgical endodontic treatment using microscope and ultrasonic tips resulted in significantly better therapeutic outcome compared to traditional techniques that did not use microscope and used burs for retrograde cavities preparation (91.1 % vs 44.2 %, p < 0.0001) [13]. This further supports the use of modern technology, including microscopy, as a standard of care in modern surgical endodontic treatment. Nevertheless, only 9 % of general dental practitioners routinely used dental magnification in one Scottish study [14]. Similarly, another study reported an increase in the use of dental loupes among general dental practitioners (44 %). However, a lower percentage was reported for graduated dental students (28 %) [15]. This underscores the importance of increasing the awareness of using dental magnification in our profession, and emphasizing the use of dental magnification early in dental schools.
Limited numbers of studies have been published on the use of dental magnification among dental students and residents. Maggio et al. conducted a study on the effect of magnification loupes on the performance of preclinical dental students. Students using magnification loupes worked faster, completed more teeth preparations, used computer-assisted evaluation less frequently, and demonstrated better overall performances [16]. Similarly, a recently conducted study on dental interns and final year undergraduate students, showed statistically significant improvement in the outcome of class II cavity preparations for those using magnification loupes [17].
Thus, the aim of this study was to assess the awareness and attitude, among dental students and residents at King Abdulaziz University, Faculty of Dentistry (KAUFD), toward using dental magnification.
