So much is on these forums that it is hard to sort through it all.

I have tried to
organize some of it.
1) Is a microscope right for your office? If you are reading this thread, I am
guessing that it is ready. A microscope is like all new technology, some will
embrace it and some will not. Talk with some microscope users. I do not know
any who have regretted this purchase. I cannot say the same of any other
technology. This technology is definitely here to stay.
2) Pros
a. Magnification-Obviously this is the prime reason to get a microscope.
One can see an entirely new perspective on every aspect of dentistry under
extreme magnification. Cracks are prolific. Many cracks should be treated at a
stage that can only be found under high power. This is an advantage to both the
dentist and patient. The patient avoids fracture of the tooth. The dentist is able to
treat the tooth with appropriate cuspal coverage. Coverage can help avoid many
of the problematic sensitive filling that have been difficult for which to find causes
in the past. There are many times when decay, poor restorations, and other
problems are found that could not be seen otherwise. I will not try and cover all of
these issues here.
b. Lighting-When viewing an object through a microscope, there is NEVER
a shadow. The light source comes from within the microscope. If one looks
directly at an object, the light is direct to where you look. If one looks through
their mirror, the light will follow your reflection.
c. Posture-With the microscope, one can always sit up straight. Not only
will your back be straight but so will your neck. The posture is much improved
over posture with loupes.
d. Quality of dentistry- Speak with a microscope user. Every microscope
user I have spoken with tells me that their work quality after using a microscope
is better than their work quality before using a microscope.
3) Cons
a. Price- Entry to the world of microscopes can be high. While there are
some inexpensive models available, most are going to want a microscope that is
fairly expensive. The great thing though is that a microscope does not require the
frequent expensive upgrades and maintenance that many high tech products
require. A microscope purchased today will last much longer than any other
technology that I can think of purchasing.
b. Learning curve- Attention has been brought to the learning curve to a
new microscope user. I think too much attention. Sure it takes time to learn, but
one can always push the microscope away and finish the procedure with
traditional techniques while learning. With time anyone can master the use of the
microscope. There are also many teaching aids available including DVD,
classes, and personal in office training. When I say anyone can learn the
microscope, I mean anyone. Some will learn faster and some slower, but
everyone can get to proficiency.
c. Associate- I have heard some say that as an associate, they do not
have the option of using a microscope. My question is how many associates
have purchased loupes? The answer is most. It could be the same with a
microscope. A microscope can be purchased that is on a floor stand. If one were
to purchase a microscope in this manner, it could leave the office if the associate
were to move to a different practice.
4) Brands- Currently there are three major brands for dental microscopes. All
brands have many different models. The brands are Zeiss, Global, and Seiler.
There are major differences between them analogous to the differences between
the most inexpensive high speed handpiece and the most expensive electric
handpiece. Which brand is best for your office? No one can tell you that. Just be
aware that they are indeed very different. It is best to take a lot of time to figure
out which is correct for your own personal needs, for this purchase could be with
you for an extremely long time.
5) Lighting- Lighting, as mentioned previously, is always without shadow. There
are many different light sources available. Halogen is the least expensive and the
least bright. It is frequently good enough for viewing, but complaints arise when
the practitioner tries to take photographs. Some will have a problem with dark
photographs with a halogen light source. Metal halide lights are the other choice.
Xenon light sources seem to be the most common of this category. Xenon light is
much brighter and is definitely an advantage in photography. Before you decide
which light is for you, please read the photography section.
6) Other options-Many options are available for a microscope to be more
comfortable to its user. The two most common are angled optics and rotatable
optics. Angled optics let one move the binocular up and down and keep a
perfectly aligned neck and back. Slouching is more easily avoided with angled
optics, and one does not need to move the patient as frequently. Rotatable optics
allow one to move the microscope off the vertical plane and still keep the
binocular horizontal to the floor. This feature is arguably less important than the
angled optics, but I find it to be of frequent use. Other options are being used and
developed. Some of these are laser filters, MARA adapter (similar to rotatable
optics), electronic movements of the microscope, etc.
7) Photography
a. Photography becomes very accessible with a microscope. A camera
can be permanently attached to a microscope and at anytime ideal
documentation may be achieved. People who think they will not be interested in
photography should really think carefully about this decision. If it is possible that
photography may be introduced into the practice at a later date, the lighting issue
should be revisited. Photography with a halogen light source will be sufficient for
most practitioners, but some will want better light for a better photography result.
Along with fabulous documentation, comes the ability for fabulous patient
education.
b. Parts- To attach a camera one will need a couple of different
microscope parts.
i. Beamspliltter- Microscope manufacturers make a part which will
divert a portion of the light away from the eyes and can be used in
different ways.
ii. Photoadapter- The camera does not attach directly to the
beamsplitter. The photoadapter acts as a go between the camera and the
 beamsplitter. The two major photoadapters that I am aware of are the
CarrII photoadapter and the X-mount.
iii. Connectors- Connectors are minor parts that link the camera,
photoadapter and beamsplitter.
8) Video- Many microscopes users have found value in attaching a video
camera to the microscope
. a. Assistant- Dentists may use video exclusively for the advantage of the
assistant. A monitor can be placed area easily seen by the assistant. The ability
of the assistant to anticipate increases when viewing the procedure to such a
high degree.
b. Patient- Dentists may use video for advantage of the patient. A monitor
may be placed above the dental chair. When the patient is reclined, live video of
the entire procedure may be seen. The monitor is best placed directly above the
patients head when fully reclined and slightly on the side of the assistant. Many
dentist combine these options and have multiple monitors. Matt Brink