The Application Of Dental Operating Microscope In The Root Debridement During The Periodontal Flap Surgery

Objective: With the popularity of Dental Operating Microscope(DOM)in the field of oral treatment,the application of DOM in periodontal surgery has gradually been promoted.According to reports,the most common reason for not using the DOM is that it is difficult to grasp a suitable location and it is difficult to operate it for the first time,especially in periodontal area where the observation and manipulation of the site are more complicated.Therefore,finding the best operating position is a key factor in the successful use of the DOM.In this paper,a series of relatively reasonable positions and angle ranges were obtained by statistical analysis of the position and angle of periodontal microsurgery performed by periodontal surgeons of the China Medical University Hospital of Stomatology.Methods : This study is divided into two phases.The first stage is the research of imitating head model,has selected 17 doctors who has been awarded the qualifications of medical practitioners and have received a periodontal specialist training 2—3 years.Evaluation of best operating points on the side of the lip(cheek)tongue(sacral)on11,13,23,31,33,43,16,26,36 and 46 by Visual Analogue Scale/Score(VAS).And observed the left and right declination angles between the sagittal planes of the dummy head and vertical planes,the angle between the jaw plane and the horizontal plane and the use of the mouth mirror.The second phase is the clinical verification period.11 attending doctors at the department of periodontology in china medical university hospital of stomatology were selected to verify the results of the simulated head model study period during clinical operations,and revised opinions were proposed to improve the experimental results.Results: 1.Simulated head model study period:(1)Doctor operating position: 11,13,23 lip side best operating point is 8,9 points,temporal side is 11,12 point.31,33,43 lip and tongue side are all at 12 points.the best operating points of 16,46 buccal and 26,36 tongue sides are 8,9.the buccal sides of 26,36 and 16,46 tongue are 10,11 Point.(2)Angles between the sagittal planes and vertical planes of imitation head mold: After multiple statistical analysis,11 and 31 left and right declination angle of imitation head mold sagittal plane with the vertical plane is 4 ± 5 ??°,13 with 43 is-9±8°,23 to 33 is19±8°,16,46 buccal side and 26,36 lingual side is-27±11°,26,36 buccal side and 16,46 lingual side is 31±13°.(3)The angle between the jaw plane and the horizontal plane of imitation head mold: After multiple statistical analysis,the angle between the jaw plane of the maxillary teeth and the horizontal plane is 88±7°,and the angle between the jaw plane of the jaw teeth and the horizontal plane is 55± 8.(4)Whether oral mirror is used:No oral mirror is required on the lip(cheek)side of all the tested teeth and 36,46 lingual side,and the others are required to use the oral speculum.The distal surface of posterior teeth requires the oral mirror reflex to observe clearly.2.Clinical verification period:After test and verify by 11 attending doctors,it was found that the VAS values ??of the comfort degree of the simulated head model study period were all below 4,and it was considered that the position and angle of the simulated head model study period were feasible.Conclusions: When using the DOM for periodontal flap retraction,appropriate doctor and patient positions should be selected for different dental positions,thereby improving the operating efficiency.