The Surgical Operating Microscope in Restorative Dentistry: Treatment of Second Molar Distal Caries Around Mesially Impacted Wisdom Teeth

A challenging problem of restorative dentistry is the diagnosis and treatment of distal surface caries on a second mandibular molar, resulting from chronic food impaction between the second molar and a mesio-angular impacted mandibular third molar located distal to the second molar. Decay removal is difficult due to compromised access, visibility and lighting. Placing a matrix band around the second molar class II preparation may be difficult since the proximal box may be located on undercut, subgingival or concave root structure. Due to access, lighting and visibility challenges, it is suggested that dentists use a surgical operating microscope, or binocular surgical telescopic loupes of 6-8x magnification or greater, combined with co-axial illumination, when treating these lesions, instead of using unaided vision and overhead lighting.