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Enhanced Visualization in Periodontal Therapy: A Clear Picture of Better Patient Care

Course Number: 653


Enhancement of visual acuity through the use of magnification loupes is common in medicine and dentistry.27 Loupes can provide magnification of 2 to 8x magnification and are used extensively during dental therapies, including nonsurgical and surgical periodontal therapies.28 There are two general types of loupes that are used in dentistry: Galilean loupes and Keplerian (or prismatic) loupes.28 Galilean loupes are composed up a set of lenses—a convex objective lens and a concave eyepiece lens. Galilean lenses generally have a magnification of 2-3x and offer depth and width of visual field that cannot be achieved with a single lens (i.e., simple loupe).28 Keplerian loupes feature two or more positive convex lenses and can achieve magnification up to 8x.28 Due to the number of lenses, Keplerian loupes tend to be heavier and offer a limited width of field, but newer materials, including high index, lightweight glass, can remedy these issues.28

Of the currently available enhanced visualization technologies, magnification loupes are the most used in dental practice. It has been reported that up to 66% of dentists utilize loupe magnification for some or all of the procedures that they perform, although a significantly lower percentage of dental hygienists reported loupe use.29-31 The use of loupe magnification has demonstrated improved operator ergonomics, clinician comfort, and decreased incidence of musculoskeletal injury.32-35 Furthermore, in novice dental and dental hygiene practitioners loupe use was associated with improved visual acuity.36 It has also been suggested that loupe magnification may allow for enhanced visual acuity that can overcome age-related visual acuity loss associated with presbyopia in older dental practitioners.37 Additionally, clinical outcomes after closed ScRP, including scanning electron tooth root surface roughness and inadvertent removal of cementum/root gouging were improved when 2.5x loupe magnification were used.38 However, no such advantages to the use of loupe magnification were seen when they were used to improve visualization during supragingival scaling procedures.39