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Why Dentist need Binocular loupes for dental working or operation?

 Magnification lenses used in dentistry have improved significantly in the past decade. During the mid-1980s, veteran dentists were still wearing the single-lens, flip-down loupes, featuring tiny opera-like glasses protruding at an angle from a fixed metal bar. The loupes were held securely to the operator's forehead by a narrow band. When chairside, the dentist could flip the metal bar down, lean in toward the patient until the magnified image was properly focused, and begin treatment. 

Improvements in magnification lenses have made them an asset to many dental professionals, including those without natural visual impairment. In the academic setting, many dental and dental hygiene students purchase loupes as they begin their preclinical exercises.  

Does the use of optical magnification improve clinical skills? The natural assumption is the bigger the object, the better we see, thus, the better we work. Dental studies using magnification technologies available in the mid-1990s provide conflicting evidence. A study conducted by Donaldson et al evaluated 52 third-year dental students, performance on amalgam preparations in a pediatric setting.1 Students were randomly assigned to wear or not wear loupes. Students using loupes were allowed to choose from 1.75 magnification clip-on loupes or 2.0 magnification frame-mounted loupes. Tooth preparations performed at baseline were compared to tooth preparations done after 8 weeks of clinical practice. Outcomes at both intervals were based on student self-evaluations. The authors reported no significant differences in clinical outcomes between groups at baseline or final evaluation. 

A study of simulated patient care produced contrasting results. According to Leknius et al, student performance was enhanced by using loupes. In this study, 155 students in a preclinical prosthodontics lab practiced restorative preparations by trimming prepared dies. A cross-over study design was implemented, allowing both groups the use of visual magnification. All final products were evaluated by the same technician for errors. Results indicated that student performance was significantly enhanced with the use of loupes. 

Musculoskeletal injury induced by improper ergonomics and compromised postures is also of concern to dental professionals. Does the use of optical magnification improve posture, thereby reducing the risk of musculoskeletal injury? 

A study by Branson et al shows promising results. This randomized crossover design study evaluated the posture of 22 senior dental hygiene students during a periodontal probing exercise. Student performance was videotaped with an overhead camera and then evaluated using the Branson Posture Assessment Instrument (PAI). PAI ratings of acceptable, compromised, or harmful are based on 10 components of posture. Dental hygiene faculty who previously calibrated on the PAI system served as evaluators. Though posture was deemed acceptable with or without loupes, the authors reported significantly less deviation from the ideal neutral posture when students wore magnification lenses. In addition, the study surveyed student opinion concluding that most participants found the loupes comfortable and perceived an improvement in the quality of their work and posture. 

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