A modified combined indirect ophthalmoscope and illuminated magnifying loupes

A modified combined indirect ophthalmoscope and magnifying loupes with illumination was made by mounting a pair of Zeiss loupes below the SOLA indirect ophthalmoscope eye-piece. A beam-splitter, which was made of a piece of ordinary microscopic glass slide, splits a secondary light beam off from the original light source of the indirect ophthalmoscope at an angle of ˜15° to provide additional illumination for the magnifying loupes. The optics involved was discussed.     

Endodontic therapy using magnification devices: A systematic review

Objectives

The purpose of this systematic review was to investigate if the use of magnification devices in endodontics is associated with the improvement of clinical and radiographic outcomes.

Data

The treatment success as determined by clinical and radiographic evaluation after 1-year follow-up was the main outcome. The main search terms used alone or in combination were: endodontic treatment, endodontic therapy, endodontic surgery, apicoectomy, periapical surgery, microscope, endoscope, loupes, magnification devices.

Sources

The authors searched MEDLINE, Embase, Cochrane Oral Health Specialized Register, Cochrane Central Register of Controlled Trials for articles published up to September 2009 plus hand-searching of relevant journals and reference list of pertinent reviews and included studies.

Study selection

Prospective clinical trials comparing endodontic therapy performed with or without using magnification devices, as well as trials comparing two or more magnification devices for endodontic therapy were considered.

Conclusions

Three prospective studies were included, all dealing with endodontic surgery. No significant difference in outcomes was found among patients treated using magnifying loupes, surgical microscope or endoscope. Similarly, no difference was found with or without using the endoscope. No comparative study on magnification devices was found regarding orthograde endodontic treatment. The type of magnification device per se can only minimally affect the treatment outcome. Well-designed randomized trials should be performed to determine the true difference in treatment outcomes when using a magnification device in both orthograde and surgical endodontic treatment, if any exist.     

口腔技师使用放大镜及显微镜的人体工程学效果评价研究

目的　研究放大镜及显微镜对口腔技师实操应用时的人体工程学影响，对比裸眼、放大镜及显微镜工作条件下技师的工作姿势，从人体工程学的人体姿势评价指标对放大镜及显微镜工具的实操应用价值进行对比评价。方法　在四川大学华西口腔医学技术教研室选择3名已熟练掌握放大镜及显微镜工具的技师，进行前瞻性随机对照试验。试验前在操作位置的矢状位、俯视位、背侧位分别安装相机设备，每人依次在裸眼（A空白对照组）、3.5倍头戴式放大镜（B放大镜组）和9倍技工显微镜（C显微镜组）下，瓷贴面采用椅旁计算机辅助设计（CAD）与计算机辅助制造（CAM）设备切削底层+饰面的设计方案，按照标准流程分别完成5颗右上中切牙瓷贴面的制作，全程通过录像完成姿势记录。每次操作完成后，采用OpenPose对视频数据的人体姿态进行识别，而后使用MATLAB计算上肢工作姿势中手臂、手肘、手腕、颈部及躯干角度等各关节角度，计算对应的快速上肢评估（RULA）分值，同时结合记录的实操时间进行人体工程学优势评价，采用SPSS 26.0统计学软件对汇总数据进行统计分析。结果　人体上肢关节角度分析结果显示，裸眼组的手臂、手肘、手腕、颈部及躯干角度分别为14.93°±9.44°、120.19°±2.99°、23.97°±2.84°、47.27°±5.72°及7.76°±2.30°，上述各关节角度在3组间的差异均具有统计学意义（P<0.05）；与裸眼组相比，颈部及躯干角度在放大镜组分别降低了29.09%和42.53%，在显微镜组明显分别下降了43.99%和87.11%。通过LSD方法进行多重比较，在颈部角度与躯干角度中，裸眼组和放大镜组间的差异有统计学意义（P<0.05），裸眼组和显微镜组间的差异有统计学意义（P<0.05），放大镜组和显微镜组间的差异也具有统计学意义（P<0.05）。RULA分值分析结果显示，裸眼组、放大镜组和显微镜组的RULA平均值分别为（6.24±0.34）、（5.53±0.35）、（3.31±0.19）分；与裸眼组相比，放大镜组的RULA平均值降低，显微镜组的RULA平均值显著降低，各两组间的差异均有统计学意义（P<0.05）；显微镜组的RULA平均值比放大镜组的显著降低（P<0.05）。实操时间的分析结果显示，裸眼组、放大镜组和显微镜组的平均实操时间分别为（50.69±36.78）、（52.01±34.65）及（59.44±35.81）min，3组间的差异无统计学意义（P>0.05）。结论　放大镜和显微镜均能改善口腔技师实操时的人体工作姿势，在有利技师的人体工程学便利上，显微镜有更好的效果。