AMED Certified Microscope User Requirements:

a. AMED Member for 2 years
b. Passed 2 levels of microscope skills test
c. Approved by the AMED Board/Certification committee
d. Attend AMED Annual meeting Certification Ceremony


LEVEL ONE – Restorative
Exercise A) Identification of the Microscope Parts
The candidate will be asked to identify the following parts of the microscope and briefly describe its function:

  • Oculars
  • Ocular fine focus ring adjustment
  • Beam Splitter
  • Camera Mount
  • Magnification adjustment mechanism
  • Fine focus adjustment of the scope or Variable focus adjustment knob
  • Main focal lens

Exercise B) Doctor Seating and Ergonomics

The candidate must be able to be seated and adjust their seating position. Thighs should be between 90 degrees to 110 degrees to the floor. The spine should be straight with no forward lean. Head should be in a neutral, relaxed, and balanced position over the shoulders. The eyes should be looking forward and the line of sight parallel to the floor. Arms should rest on the arm supports of the operator chair or be supported and braced against the operator’s sides.


Exercise C) Par Focusing the Microscope


The candidate must demonstrate without assistance or coaching the ability to par focus the microscope either the operator specific par focusing technique or the video-based technique.

If the candidate elects to do the operator specific technique the examiner will assist the candidate in video par focusing the scope in order to observe the examination on the monitor.


Exercise D) Dialing in the Object Tooth


The candidate will be evaluated by bringing the object tooth into focus at a field of view of up to 4 teeth. The candidate may begin at a lower magnification but must complete the exercise in the area of 8X magnification.  

The candidate must be able to bring tooth #8 into view, use a mirror to visualize the lingual surface and examine the tooth with an explorer. The candidate will then turn to either tooth #3 or tooth #14 (candidate choice) and repeat this exercise.


Exercise E) Crown Prep #8


The candidate is permitted to begin at a low magnification but must complete the exercise at a field of view of 3 teeth with an es)mated magnification of 8X.

The candidate will prepare the facial of tooth #8 then proceed to the mesial and distal proximal reduc?ons. The candidate is not permitted to impact or damage the simulated gingival issue.

The candidate is allowed to utilize a proximal barrier to protect the adjacent teeth from iatrogenic injury. If the adjacent teeth are damaged to the extent that polishing will correct the defect the candidate will be allowed to pass this section.

If the candidate impacts the adjacent tooth/teeth to the extent the tooth would require restoration the candidate will fail this exercise.  

The candidate will proceed to the lingual and prepare the tooth with indirect vision. The margins must connect and be contiguous around the tooth.


Exercise F) Crown Prep Either #3 or #14 – Candidate Choice


The same criteria are applicable as in the anterior tooth Exercise E. No damage to the simulated gingival issue and no damage to the adjacent teeth what would require restoration.


In Exercises E and F the Examiners are looking for how well the candidate can control the operating instruments and the candidate’s ability to obtain good focus on the object tooth and remain in focus centered in the field of view.

The candidate must also demonstrate the ability to operate at a level of magnification 8X with fine motor control and confidence.


LEVEL TWO – Restorative

The candidate is expected to perform without coaching or assistance the following:
Exercise A) Doctor Seating and Ergonomics
Exercise B) Par Focusing the Microscope and Video
Exercise C) Dialing in the Object Tooth
Exercise D) Full Crown Prep Anterior Tooth #24


All the same criteria apply from the Level I examination. The crown prep must be completed to the point the tooth is ready for the impression. The margins must be finished and polished.

The candidate may begin the exercise at a lower magnification, but the candidate must demonstrate control and mastery with a single tooth operating field of view. The margins must be refined and polished at 14X.

The candidate must use the mirror with indirect vision at 14X.


Exercise E) Posterior Tooth Preparation. (Candidate option: MOD Onlay Prep #30 or Full Crown Prep #19)

The candidate may select the procedure. The same criteria apply to these procedures as to the procedures from Level I preparations.

The crown prep or the onlay prep must be completed and ready for impression. The margins must be finished and polished at 14X and a mirror must be used during the procedure at the 14X level.

After passing level one, the operator must perform the following skills. The operator can choose from any one of the specialty appropriate procedures listed to display skill and proficiency.


1. Keep working field in focus and centered with an indirect vision for 70% of a ten-minute specialty appropriate procedure utilizing at least 8x magnification for at least one minute of the procedure.


The operator can choose any of one of the three:


a) Crown preparation procedure
b) Endo Access
c) Periodontal scaling with sonic or ultrasonic or periodontal bone recontouring with a handpiece

  1. 2. Perform procedures in three quadrants.
    The operator can choose any of ONE of these FOUR:

a) Crown preparation procedure

b) Endo access

c) Periodontal sonic scaling or periodontal bone recontouring

d) Use scalpel and suture with direct vision


3. Utilize three levels of magnification with any maxillary procedure.
4. Utilize two levels of magnification for mandibular procedures.
5. Perform direct vision mandibular procedures on posterior teeth.

Skills Test Checklists:
There will be two examiners testing each candidate to prevent bias.

Level One:


There are 7 items on the level one checklist:
1. Identifying microscope parts and their uses
2. Par Focusing
3. Position Operator and Patient
4. Indirect Treatment on maxillary arch
5. Treatment in 2 Quadrants
6. Use 2 levels of magnification
7. Procedure in focus and centered on the video monitor for 50% of a five-minute procedure.  

Items 3-7 can be tested simultaneously to make the exam easier to grade and quicker. 


1. Have the candidate identify microscope parts and uses


2. Candidate sits down at the scope and par focus it to start working – If the candidate cannot par focus to video, an examiner will do that part after the candidate demonstrates that they can par focus the scope. (To Pass level 2, the candidate must be able to video par focus)


3. Then they Prep Tooth #8, using two levels of magnification while keeping procedure field in focus and centered on the video monitor, using direct and indirect vision and proper positioning with or without microsurgeon chair armrests.

Use of the armrests is not required. While they are prepping #8 for five minutes, the examiners can check the candidate’s ability to do all of the checklist items, and can ask the candidate to switch to indirect vision, etc…

The candidate is permitted to begin at a low magnification but must complete the exercise at a field of view of 3 teeth with an estimated magnification of 8X.

The candidate will prepare the facial of tooth #8 then proceed to the mesial and distal proximal reductions.
The candidate is not permitted to impact or damage the simulated gingival issue.

The candidate is allowed to utilize a proximal barrier to protect the adjacent teeth from iatrogenic injury. If the adjacent
teeth are damaged to the extent that polishing will correct the defect the candidate will be allowed to pass this section.

If the candidate impacts the adjacent tooth/teeth to the extent the tooth would require restoration the candidate will fail this exercise.

The candidate will proceed to the lingual and prepare the tooth with indirect vision. The margins must connect and be contiguous around the tooth.

4. Then they Prep Tooth #3 or 14 – Candidate’s Choice:

The same criteria are applicable as in the anterior tooth Exercise E. No damage to the simulated gingival issue and no damage to the adjacent teeth what would require restoration.

In Exercises E and F the Examiners are looking for how well the candidate can control the operating instruments and the candidate’s ability to obtain good focus on the object tooth and remain in focus centered in the field of view.

The candidate must also demonstrate the ability to operate at a level of magnification 8X with fine motor control and confidence.

 

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