Microscopic Endodontics

The dental operating microscope provides magnification of up to 25 times and coaxial illumination directly aligned with the field of view, allowing the internal anatomy of a tooth to be examined in detail that is not visible to the unaided eye or with surgical loupes alone. In endodontics, this level of magnification is significant because much of the work takes place inside canal spaces less than a millimeter in diameter, where missed canals, calcifications, cracks, separated instruments, and perforations can determine whether a tooth heals or requires further treatment.

At Tri-City Endodontics, the operating microscope is used throughout diagnosis and treatment rather than only at selected steps. Applications include locating additional canals that may be missed without magnification, such as the MB2 canal in upper molars, identifying cracks extending from the chewing surface or pulp chamber floor, removing previous root canal filling material and separated instruments during retreatment, performing apicoectomy and root-end preparation with controlled access through small surgical openings, and managing perforations and resorptive defects where precise placement of repair materials is required. Procedures performed under the microscope are documented with integrated photography and video when relevant, which supports communication with patients and referring dentists about the findings inside the tooth.

Dr. Malhan and the Tri-City Endodontics team routinely receive referrals from general dentists throughout the Tri-Cities region for cases where microscopic visualization is expected to change the diagnosis or the treatment outcome. Findings observed under magnification, including features that cannot be seen on radiographs or with conventional examination, are reviewed with the patient so that decisions about treatment are made with a clear understanding of the actual condition of the tooth