The dental microscope and its components Binoculars. Parfocal adjustment. Diopter. The dental microscope and its components

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1 Vergroting in de Tandheelkunde Prof. P. Lambrechts, KULeuven The dental microscope and its components Binoculars (inclinable) Spring arm Magnification Eye cups changer Microscope body Light box Microscope body Floor stand Maneuvering handles Objective with fine focus The dental microscope and its components Parfocal adjustment. Diopter. 3 Do you treat with or without glasses? Caution! The binoculars include as well diopter setting swivels. To set please perform a parfocal adjustment. The procedure will be described soon. Individually adjust the Operating Microscope Please make sure before using the scope that the ocular cups are set to your demands. Ocular rubbers with glasses: turned in with the bare eye: turned out Screwed cups for the use with glasses. Unscrewed cups for the use without glasses. Kasper Veenstra 1

2 Bipupillary distance Adjustment of the bipupillary distance Operated with both hands. Adjust the binoculars to your personal bipupillary distance. You look through the oculars and at the same time adjust them by moving the tubes up or down until you see one circle without double vision. Kasper Veenstra Global No indication of bipupillary distance. Operated with two hands. Poor indication of bipupillary distance. Operated with two hands. Optomic Leica M No indication of bipupillary distance. Operated with one hand. Unprecise indication of bipupillary distance. Operated with one hand. Labomed

3 Indication of bipupillary distance. Operated with one hand. Precise indication of bipupillary distance. Operated with one hand. ATMOS Opmi Pico ZEISS Focus the microscope... Focus the microscope... At first the rough focus is set by moving the body up or down. Then the fine focus is set by moving the lever at the objective either clockwise or counter-clockwise until the object appears in sharp condition. Objective with fine focusing Focusing range 12 mm (KAPS) Focusing range 13 mm (ZEISS, PICO) Focusing range 17 mm (ATMOS) Focussing range 20, 25 mm (Global) Caution: Before using the scope please perform a parfocal adjustment. Focus the microscope... 3 step combination Focus the microscope... Medium Course KAPS SOM 32 dent Motorized/Zoom focus Fine ZEISS Motorized focus 3

4 Motorized focus and Autofocus If CCD camera is connected, autofocus is possible KAPS Balance 1400 Motorized zoom Varioscope module Manual and motorized zoom The magnification is continuously adjustable. From overview to details. Varioscope module 50 ( mm variable working distance) Varioskop 100. ZEISS. OPMI Pico ( mm variable working distance) - Vario: without moving the microscope or changing the working position the area of treatment stays in focus. - Because of multiple lenses, a lot of light is absorbed! Available March Varioskop. ZEISS. OPMI Pentero ( mm variable working distance) VarioZoom. ATMOS ( mm variable working distance)(under construction) A new Varioskop, provides a larger working range and virtually ensures comfortable working conditions - even when using long instruments. The depth of field has been increased by 17% and can be doubled by activating the DeepView function. Modification of fine focussing to manual VarioZoom

5 How to move the microscope system... Permanent balance Möller Wedel Allegra30 ATMOS iview 31 The Maneuvering Handles Permanent balance, because the microscope rotates cardanically around its center of gravity. The position of the handles may be adjusted for maximum comfort. This is done by first grasping the handle; then with your thumb on the release button pull outward on the handle and rotate into the desired position. Releasing the handle will lock it into place. Balancing coupling Free motion balancing coupling KAPS Balance 1100 Handgrips with "single hand" motion control This coupling offers ultra-smooth, fluid and perfect balance during repositioning of the microscope. Free Motion balancing coupling with magnetic locking clutches. By pushing a button the microscope will float weightlessly and can be locked in any desired working position. Weightlessly floating with Magnetic Clutches. KAPS Balance Free-floating magnetic system Free-floating magnetic system Varioscop/LED The microscope can be floated into any required position with the ultimate ease thanks to the electromagnetic clutches. Fine and precise adjustments of the body are possible. KAPS Balance 1450 KAPS

6 Zeiss OPMI PRO-Magis Free Float Magnetic System How to move the microscope system... The diagonally motion of the microscope system can be controlled with the lock knob as shown. Motorized Fine Focus & Zoom Target illumination Spot illumination Note: You can adjust the lateral aligned position of the scope by turning the optional rotation ring contrary! You keep an upright posture! You may fix the desired position by tightening the lock knob. Pico Mora Interface. 25 tilting Mora Interface. 25 tilting This mechanical optical rotating assembly allows a 25-degree tilting of the microscope body with respect to the binoculars, to accomodate the surgeon in the area of working Rotating ring. 25 rotation Rotating ring. 25 rotation +/- 25 Rotation Global Zeiss, Pico Leica, ErgoWedge TM & ErgoOptic Dent TM 6

7 Rotating ring. 25 rotation Rotating ring. 25 rotation The 60 adaptor contains a rotatable ring to move the occulors into a horizontal position, even when the microscope is titled sideways. ATMOS 37 Möller Wedel Allegra The counterbalance arm. Spacestation The counterbalance arm is especially useful when the microscope head is unbalanced caused by lateral accessories such as camera or video units. You gain back the counterbalance by adjusting the counterbalance arm. Balancing system Extensions. Redundant. You adjust the counterbalance as follows: Unlock the knob. Move the skid until the microscope head is counterbalanced. Fix this setting by tightening the knob. The microscope head in retrograde working direction... Magnification. How to achieve it? Operating Microscope 3, 5 or 6 steps magnification-changer by hand Manual zoom for continuously adjustable magnification Motorized zoom for continuously adjustable magnification Fig. 1 Fig. 2 Möller By loosing Wedel the lock knob (Fig. 1) you may Denta set the300 vertical tilt of the microscope head as shown (Fig. 2 and 3). The setting can be balanced by inclining the binoculars contrary (Fig. 2 and 3). 3 steps 5 steps 6 steps Continuous Fig. 3 Retrograde working direction 7

8 Magnification. How to achieve it? What decides the magnification? Operating Microscope 3, 5 or 6 steps magnification-changer by hand Manual zoom for continuously adjustable magnification Motorized zoom for continuously adjustable magnification 10x, 12,5x, 16x, 20x Global Protege Choose wide field eyepiece lenses (10x, 16x) Final Magnification (2x - 27x) KAPS Balance 1300 Manual zoom KAPS Balance 1300 Motorized zoom Magnifiaction changer 3.2x 4.2x 6.4x 9.6x 13.2x 5 Steps magnification 200, 250, 300 mm Differences in objective lenses 200, 250, 300 mm mm Inner diameter Objective lenses (200, 250, 300, 400 mm) Objectives with fine focussing (200, 250, 300, 400 mm) The Others Global Ultra-wide aperture for beter light transmission f-binocular tube = focal length of the tube: 160 or 170 mm f-objective = focal length of the objective: 200, 250, 300, 350, 400 mm G = factor of the magnification changer: 0,33x / 0,5x / 0,8x / 1,25x / 2x / 3x M-eyepieces = Magnification of the eyepieces: 10x or 12,5x SFZ = 22 mm M-total = Final Magnification Calculation of the Final Magnification M-total = f-tube / f-objective x G x M-eyepieces Calculation of the Diameter of the Visual field D-Vf = M-eyepieces x SFZ of 22 mm / M-total D-Vf = Diameter of the Visual field (mm) Non inclinable optical tubes Binoculars Binoculars KAPS Posture 180, 210 inclinable binoculars are a critical tool for working ergonomically Inclinable ZEISS 8

9 Inclinable binoculars Inclinable binoculars Leica ATMOS ZEISS Interchangable binoculars Dynamic foldable tube Zeiss, OPMI ProErgo The highly flexible tube f170/f260 offers increased positioning capability, magnification and user comfort. Zeiss, OPMI Pentero C ATMOS ATMOS with ZEISS inclinable binoculars Carr Binocular Extender 45 angled Beam Splitter Without With Flat beam splitter 45 angled beam splitter 54 9

10 60 Ergowedge 50/50 Beam Splitting for halogen 80/20 Beam Splitting for Xenon or LED Leica ErgoWedge TM 55 Picture adaptor Beam splitter Typical beamsplitter Global concept Partially reflective coating Cube prism Beam splitting Totally reflective coating across a very small area Cube prism Remaining area is completely transmissive Optical extensions? Redundant. Video Still Camera Video/Photo-Kombi SLR-Camera 10

11 Global concept Totally reflective coating across a very small area Global HDMI compact camera Cube prism Remaining area is completely transmissive 62 Möller Wedel Specialy designed for dentistry Denta 300 Third viewing channel for video camera Integrated video-camera Integrated mono CCD camera Bipupillar mm distance Magnification Focus Denta 300 Zeiss integrated HDMI camera HD-Imaging-Port. Carsten Jung

12 Sony Alpha NEX-3/NEX 3/NEX-5 E-mount bajonet Foto & Video AVCHD (Full HD 1920 x 1080i) life streaming video 14.2 megapixel Exmor APS HD CMOS-sensor Fototube with e-mount bajonet, (Chinese) Fototube with e-mount bajonet, (Chinese) Dual Iris Diaphragm Light sources Halogen light, Metal halide light, Xenon light, LED light Glow bulb Global Glow bulb 150 W Halogen Kaps Enables surgeons to choose between maximum light and resolution or depth of field Fiberoptic coaxial Intensity controlled Single or double channel 12

13 Optomic Halogen. Cold light source. ZEISS Halogen Light filters The Novalux metal-halide light, Global Please plug the light cable into the light output of the Novalux. Orange filter: - Prevents premature setting of resin composites Green filter: -Helps to detect blood vessels You will find both the cable plug and the light-source in the light box. Fix the plug with the small lock screw at the light output. Novalux metal-halide Standard Without filter Vascularisation With green filter Small handy unit 24 watts kelvin (daylight quality) 500 hours life You may vary the light intensity by turning the silver lever of the aperture. The Xenon light source, Global Illumination difference Plug the light cable into the output socket of the light source. You will find the cable in the light box. Xenon X3 Option You may vary the light intensity by turning the aperture knob as shown. Illumination with a Metal-Halide (Novalux) resp. Xenon- LS Illumination with a Halogen-LS Very bright light at 100 watts kelvin (daylight quality) Also available as X4rc at 180 watts 13

14 Opmi PROergo, ZEISS The microscope can be floated into any required position with the ultimate ease. The high-speed autofocus automatically delivers razor-sharp images at all times, regardless of magnification. 80 Xenon light source LED ion illumination 50,000 Lux 83 LED Technology Cost Provides low cost of ownership, no maintenance, and is easy to use. Illumination Provides bright white illumination (daylight) evenly distributed in the visible field of the microscope. 5,500 K 5,800 K klux (at distance of 200 mm), klux (at distance of 300 mm). Operation 50,000 60,000 hours of uninterrupted operation. LEDs have no start-up delay: when switched on, they instantly deliver full light output. Touch Controls New Touch Controls for quick light intensity adjustment at your fingertips. Retrofittable Upgrade your current system. Filters Composite and Green Light Filters Available. 3 Year Warranty The longest light source warranty in the industry. No Fiber Optic Cable Needed With the direct-to-port lighting system, there is no light loss through a fiber optic cable 84 (LED without cooling in the body of the microscope. No noise.) 14

15 LED for ZEISS module Integration of LED in ZEISS module Leica M320 Leica M320 F

16 Integrated HD camera and recording system that has the ability to take a 3-megapixel still image or a MPEG-4 video and save all data onto an internal SD memory card. Leica M320 F12 Leica M320 F12 IR remote control to operate the documentation system (photo & video) with SD memory card LED Economics Xenon full power/led full power Xenon LED 93 ATMOS LED 94 ATMOS iview. New ergonomic Dental/ENT Integrated LED in the body without ventilation, no noise. EndoZoom phototube on ATMOS + NEX5N Sony IR remote trigger (for a SONY NEX-5) for activating the SONY NEX-5 digital camera via the operation panel of the microscope Excellent optical power with large exit pupil, which makes work very easy and enjoyable

17 Comparison Zeiss Pico / Atmos iview ZEISS ProErgo Floor stand, Ceiling mount, Wall mount Zeiss Pico Global Sigma Dental Systems 97 Proface (W&H) & SIROInspect (Sirona) Fluorescence Aided Caries Excavation (FACE) Diagnostic glasses filter short wavelengths below 500 nm. By contrast, light components with higher wavelengths remain visible. We get used to fancy glasses in our daily life to look in 3D. Red: Caries, infected dentine Violet light 405 nm Green: Healthy dentine Proface/SIROInspect : New and innovative caries detection The new Proface/SIROInspect light probe enables direct visual detection of caries in opened cavities. While conventional methods only offer indirect information on the extent of caries in infected dentine, Proface/SIROInspect gives dentists the ability to assess the treatment site at a glance. The FACE method Proface/SIROInspect enables selective treatment during caries excavation based on the innovative FACE method. FACE stands for Fluorescence Aided Caries Excavation. The underlying principle: Bacteria in dentine infected with caries leave metabolic by-products (porphyrins). They are not visible to the naked eye. When violet light is applied to the opened cavity, however, porphyrins fluoresce red, while healthy tooth substance fluoresces green. Diagnostic goggles with special filters enhance this effect. 101 Before excavation After excavation

18 Proface/SIROInspect offers dentists three significant advantages in their daily work: 1. More reliable caries detection An examination with Proface/SIROInspect minimizes the risk of caries recurrence. In addition, it provides more comprehensive information for treatment decisions in Caries Profunda. QLF concept Eye 2. High efficiency i in caries detection ti The dentist using Proface/SIROInspect can judge the success of caries excavation at a glance. At any stage of the process. Atmos 3. Support of minimally invasive work Proface/SIROInspect assists the dentist with selective, minimally invasive excavating and substantially contributes to maintaining the patient's healthy tooth substance. The slender design of the Proface/SIROInspect light probe also offers optimum access to the treatment site. Flexible, non-contact Inspektor Research Systems BV, Amsterdam, The Netherlands MöllerWedel Allegra 30 The MöllerWedel Allegra 30 contains a disk with the following filters: - Daylight - Softlight - Yellow (against UV radiation) - Blue (fluorescence) - Green (recognition of blood vessels) - UV filter (to protect the operators eyes) - 2 spot diaphragms (against glare) 18

19 Fluorescence based plaque detection around brackets QLF-D, Leaking Fillings Improved visibility of bacterially invoked porphyrines at plaque retention areas Improved visibility of bacterially invoked porphyrines at the tooth - restoration interface Inspektor Research Systems BV, Amsterdam, The Netherlands 2010 Inspektor Research Systems BV, Amsterdam, The Netherlands The surgical microscope OPMI Pentero for neurosurgery, ENT and spine surgery OPMI Pentero 111 fluorescence-based angiography visual analysis of vascular blood flow dynamics fluorescence-guided tumor resection. excitation in the wavelength range from 460 to 500 nm Intra-operative fluorescence fluorescence-guided tumor resection. visual analysis of vascular blood flow dynamics Intra-operative fluorescence

20 Thanks for your attention 20