Endodontic treatment – no evidence to support or refute use of magnification to improve clinical outcomes

shutterstock_6236641 - operating microscope

A range of magnification devices have been introduced for use in endodontics eg. loupes, surgical microscopes and endoscopes and their use has become commonplace. The use of loupes and microscopes has been shown to improve clinicians’ working posture but there are still questions as to whether they result in greater treatment success, reduced treatment time, and lower total costs.

To aim of this Cochrane review was to assess and compare the effects of endodontic treatment performed with the aid of magnification devices versus endodontic treatment without magnification devices.


Searches were conducted in the Cochrane Oral Health Group Trials Register, The Cochrane Central Register of Controlled Trials (CENTRAL), Medline, Embase, US National Institutes of Health Trials Register, and The WHO Clinical Trials Registry Platform. A number of manufacturers and authors were also contacted.

Randomised controlled trials (RCTs) and quasi-randomised controlled trials comparing endodontic therapy performed with versus without one or more magnification devices, an adjunct to endodontic therapy were considered. Study screening was carried out independently by two reviewers and standard Cochrane data analysis protocols were to be followed.


  • No studies met the inclusion criteria


The authors concluded

No article was identified in the current literature that satisfied the criteria for inclusion. It is unknown if and how the type of magnification device affects the treatment outcome, considering the high number of factors that may have a significant impact on the success of endodontic surgical procedure. This should be investigated by further long-term, well-designed RCTs that conform to the CONSORT statement .


This is an update of a Cochrane review last reviewed in 2009 following its original publication in 2006. As the authors note that the use of magnification devices in dentistry is increasingly common and their use has been recommended as a standard of care for endodontic treatment. However, as this review has found there is no objective evidence that the use of magnification improved clinical outcomes. What is more disappointing is that since this review’s initial publication back in 2006, no high quality trials have been conducted to assess the impact of magnification on endodontic outcomes. While three potentially relevant trials were assessed for this review, they were excluded for a range of reasons. Consequently, long-term well-designed RCTs should be performed. In order to understand if there is a significant advantage in using magnification devices or not in endodontics.


Primary paper

Del FabbroM, Taschieri S, Lodi G, Banfi G,Weinstein RL.Magnification devices for endodontic therapy. Cochrane Database of Systematic Reviews 2015, Issue 12. Art. No.: CD005969. DOI: 10.1002/14651858.CD005969.pub3

Other references

Dental Elf – 9th Dec 2011 – Use of higher magnification provides better outcomes in endodontic microsurgery

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Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

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