Practical Microsurgery

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Homa H. Zadeh, DDS, PhD

Course Description

Clinicians can only treat what they can see. Working under an operating microscope provides several advantages, including superior illumination, high degree of magnification, ability to perform precision dentistry and ergonomic posture. The outcome of surgical procedures depends on a variety of factors. Preservation of vascular supply is the key factor in wound healing. Microsurgery can significantly improve the outcome of flap management. Flap adaptation and suturing can be more precisely accomplished through an operating microscope. Perhaps the most critical aspect of intra-operative visualization is the method of illumination. The operating microscope provides superior illumination through “internal coaxial illumination,” which means that the light passes through the optics. This form of illumination does not create shadow, in contrast to external illumination of dental unit light and loops, which can create shadow. Minimally invasive surgery seeks to preserve and protect healthy tissues, specifically directing the therapy to diseased tissues. The combination of increased magnification and superior illumination allows clinicians to perform minimally invasive surgery. The operative microscope also provides a great opportunity for documentation through still and video recording, which can be used for patient education and presentation. This intense course introduces clinicians to the fundamentals of working under surgical microscopes, as well as providing practical experience with multiple surgical procedures to be completed under a microscope. This will establish a level of comfort to begin the journey toward the integration of surgical microscopes as a tool to improve clinical outcomes.

Advanced Ergonomics in Microscope Dentistry

The operative microscope can not only improve clinical outcomes, but it can help clinicians reduce physical strain, which can potentially lead to occupational injury. The present course will provide clinicians with the principles of ergonomics and how the microscope can be used as a tool for ergonomic delivery of care.

1)BIOMECHANICS OF THE HUMAN BODY AND PROPER SEATED POSTURE

  • Describe proper poster while seated
  • Postural awareness exercises
  • Ergonomic operator stool

Objective: Learn and feel biomechanics of the seated working posture and neutral posture.

2) OPERATOR POSITIONING – EACH PARTICIPANT SHOULD FOLLOW INDICATIONS

Describe proper operator position for each of the oral regions

3) PATIENT POSITIONING

  • Head Position
  • Chin Position
  • Neck Cushion

4) MICROSCOPE ADJUSTMENTS AND POSITION – COMMON PITFALLS

Microscope parfocal adjustment

  • Selection of magnification
  • Explain most common pitfalls
  • Sequence of steps

Objective: Allow clinicians to select the setting that is most appropriate for clinical care and documentation.

5) ASSISTANT POSITIONING

  • Ideal position
  • Horizontal reaching
  • Instrument transfer
  • Four-handed dentistry demo
  • Demonstrate the delivery systems and how they can impact workflow and posture

6) INDIRECT VIEW

Operator handling of the mirror for indirect view

Educational Objectives

  • Introduction to the operating microscope: features and functions
  • Para-focal adjustment and focusing
  • Positioning of operator and patient
  • Documentation under surgical microscope: still and video recording
  • Integrate the skills practiced in the microsurgical training to increase competency for flap management.

Simulated Workshop and Live Surgery

  • Step-by-step operation of the surgical microscope
  • Incision design: donor tissue harvesting and flap management under surgical microscope
  • Suture techniques for improved flap adaptation under surgical microscope
  • Immediate implant placement into fresh extraction sockets under surgical microscope
  • Soft tissue augmentation: VISTA live surgery

Tuition

Members: $2195
Non-members: $2395

Continuing Education

Each module: 16 hours of continuing education

Format

This course is conducted in-person and includes:

  • Lecture
  • Hands-on workshops
  • Live surgery demonstration

The vast majority of the time on this course is dedicated to conducting exercises under microscope. This includes exam, surgical and restorative procedures.

Course Brochure
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