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1.- INSTALLING THE MICROSCOPE

Most operators prefer a ceiling or wall-mounted microscope, as this option causes the fewest restrictions when it comes to moving around the microscope and its mounting. Sometimes, depending on the size, equipment and the way the operating theatre and clinic are "decorated", a floor- or wheel-mounted microscope may be recommended.

2.- TREMBLE CONTROL

Tremble control is one of the most important preparatory steps in the learning period and is very valuable when using microsurgical techniques, which is assessed and measured in tens of a millimetre when we are working with large magnifications. When trembling cannot be controlled it usually has catastrophic results, which, in general, lead to discouragement and demoralisation.

3.- POSTURE CONTROL

The operator’s head must be slightly bent (approximately (30º), the dental chair should be in such a position that the operator and assistant’s backs are vertical and straight, the operator’s arms should fall relaxed and parallel to the vertical axis of the microscope, and the forearms should be parallel to the floor. The length and angle of the chair’s headrest should be adapted to position of the patient’s head in the appropriate occlusal plane. There are some simple exercises we should do until our movements are harmonious and precise.

4.- WORKING POSITIONS FOR DENTISTRY

It is absolutely impossible to give a complete list of all the working positions we might possibly need when performing microsurgical procedures in the different areas of the oral cavity. Our ultimate goal is to learn how to adjust the position of both patient and microscope, and for the surgeon and assistant to find the most comfortable, least tiring and fatiguing positions, while being able to see all possible areas of the mouth.

Generally, the operator is situated at between nine and twelve o’clock, and there is a greater distance between the operator and the patient being greater. Usually, the first steps in the majority of procedures are performed at low levels of magnification, and higher magnification is used for observing the details. A lot of the time it is better to move the patient’s head, the chair or to use intraoral camera with screen, rather than needing to continually adjust the microscope.

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