Electronic apex locator

Comparative Accuracy and Reliability of Three Electronic Apex Locators in Determining the Apical Constriction of Molar Canals: A Micro-CT Evaluation

Background: Determining the correct apical limit for root canal treatment is essential for its success. This study evaluates the accuracy of three electronic apex locators (EALs) in locating the apical constriction (AC) in molar canals. Methods: Forty extracted human mandibular molars were scanned using micro-CT, and endodontic access cavities were created. Teeth were mounted in alginate, and three EALs-Root ZX-mini, Root ZX-II, and Sirona integrated apex locator-were used to measure the canal working length in dry canals and with EDTA gel. Micro-CT scans were performed with files in place, and the distance from the AC was calculated. Measurements within 0.1-0.5 mm were categorized as 'close'. Those extending beyond towards the major foramen were categorized as 'beyond', otherwise they were classified as 'far'. Data analysis was conducted with a level of significance set at 5%. Results: Most readings for all EALs were in the 'close' category, with significant differences between devices (p < 0.0001). Root ZX-mini and Root ZX-II had 74.4% and 72.5% 'close' readings, respectively, versus 51% for Sirona integrated. Accuracy did not differ significantly between dry and EDTA-treated canals (p = 0.306). All EALs demonstrated excellent operator reliability (ICC 0.996-1.00). Conclusions: All EALs accurately determined AC, unaffected by lubricants. However, Root ZX-mini and Root ZX-II outperformed Sirona integrated. All EALs showed consistent reliability.

Effect of Different Electroconductive Root Canal Irrigations on the Accuracy of Different Apex Locators: An In Vitro Comparative Study

Aim

An accurate working length (WL) estimation is fundamental to a successful endodontic therapy. The objective of this comparative in vitro research was to investigate the performance of iPex II and the Root ZX Mini electronic apex locators (EALs) in measuring root canal WL with different irrigant solutions and their relation to the electrical conductivity of irrigation solutions.

Materials and Methods

Seventy sound permanent lower premolar teeth, each with a single root and developed apices, were used. Under an X15 stereomicroscope, the real working length was determined with the aid of a #10 file. After that, teeth were placed into an alginate model, and the iPex II and Root ZX Mini were used for the detection of electronic working length with various irrigants. Seventy teeth were randomly distributed into seven groups, 10 per each group (group I: dry canal; group II: distilled water; group III: ozonated water; group IV: 5% sodium hypochlorite (NaOCl); group V: 2% chlorhexidine, group VI: 17% ethylenediaminetetraacetic acid (EDTA) solution, and group VII: 17% EDTA gel). The difference in WL was calculated by deducting real working length from its electronic working length. The study also evaluates the electrical conductivity of the seven endodontic irrigant solutions. The two-way analysis of variance (ANOVA) test was used for statistical analysis.

Results

Statistically, neither both types of EALs (P = 0.088) nor various irrigating solutions with varying electrical conductivities (P = 0.099) significantly affect the accuracy of EL estimation.

Conclusions

There were no significant differences between the accuracy of the Root ZX Mini and the iPex II. The accuracy of both apex locators is unaffected in the presence of various irrigation solutions with varying electrical conductivities in this research.

Comparative evaluation of accuracy of working length determination with fifth-generation apex locator using two different techniques: An in vitro study

Context

Accurate working length (WL) determination is essential for successful root canal therapy.

Aim

The aim of this study was to compare the difference between two different techniques in locating minor constriction using fifth-generation electronic apex locator.

Settings and Design

A detailed protocol explaining the procedures of the study was submitted to the institutional ethics committee.

Subjects and Methods

Forty extracted human permanent canine teeth were selected. WL was measured three times for each sample by three different examiners for both the conventional and experimental techniques at different time intervals. Interexaminers were blinded to their measurements, and the person who analyzed mean value was also blinded with techniques. Finally, radiographic working length was obtained using 15 size K-file. A size 20 K-file was cemented into the measured position with glass ionomer cement. Each tooth was viewed under a stereomicroscope at ×40 magnification. The distance from the file tip to the root apex was measured and calibrated to the nearest tenth of a millimeter.

Statistical Analysis Used

Using Stata statistical software (Version 17, Statacorp, College Station, Texas, USA). The agreement between raters and techniques was determined using intraclass correlation coefficient "ICC" and Bland-Altman plot.

Results

The "experimental method" (0.95, 95%) showed better agreement between the raters in comparison with the "conventional method" (0.93, 95%).

Conclusions

The experimental technique showed perfect agreement between examiners in locating the minor constriction of the apical foramen.

Working length variation during multiple-visit endodontic treatment: An observational study

This study investigated variation in working length during multiple-visit endodontic treatment. Patients (N = 106) with pulpitis or pulp necrosis, with or without apical periodontitis, were included. During the first appointment, glide path was performed with ProGlider and shaping with ProTaper Next. Working length was detected four times. Working length was then re-recorded prior to filling during the second appointment and a 0.5 mm threshold was selected as the minimum clinically meaningful variation. A logistic regression model was used to evaluate the impact of tooth anatomy, preoperative pulp status, apical periodontitis and lesions of endodontic origin on working length variation. Working length varied between first and second appointments in 34% of patients. The presence of apical periodontitis was the only variable significantly associated with variation in working length (p = 0.011). These data suggest that working length should be re-checked prior to root canal filling to prevent procedural errors.

The influence of MTAD and QMix on the accuracy of electronic apex locator in locating simulated perforations

Aims and Background

The aim of this study was to evaluate the accuracy of the electronic actual length in detecting artificial perforations of the root canal in the presence of saline solution (NaCl, (Eczacibasi, Istanbul, Turkey), chlorhexidine [CHX (Werax, Tunadent, Izmir, Turkey)], QMix (Dentsply Tulsa, Maillefer, Ballaigues, Switzerland), and MTAD (Dentsply, Tulsa Dental, Tulsa, OK, USA).

Materials and Methods

The root canals of 25 single-rooted extracted human teeth were perforated artificially in the middle section of the root. The actual lengths up to the perforation site were measured and then, the teeth were embedded in an alginate mold. Electronic measurements of the perforations were obtained by an electronic apex locator according to the manufacturers' recommendations under dry conditions and in the presence of NaCl, CHX, MTAD, and QMix using a #20 K-file. Each canal was irrigated with distilled water and then dried with paper points between the measurements. Statistical analyses were performed using the Friedman test and Spearman Rank correlation coefficient to assess the correlations between the measurement methods.

Results

Highest correlation between the actual length and the electronic measurement was observed under dry conditions and NaCl solution (r: 0.932, r: 0.940 respectively), and the least correlation was observed with MTAD solution (r: 0.697) using statistical analysis. Moreover, the accuracy of the electronic apex locator with different irrigation solutions was statistically different from each other (P = 0.001).

Conclusion

The most accurate electronic measurements of artificial perforation were obtained under dry conditions or with NaCl.

Accuracy of working length measurement by Raypex 6: Electronic apex locator versus actual measurements under stereomicroscope

Background/Aim: This study aimed to evaluate the precision of the Raypex 6 apex locator in locating the apical constriction (AC) and major foramen (MF) during a root canal treatment compared with a microscopic evaluation. Another aim of the present study was to evaluate the accuracy of the Raypex 6 in the presence of different irrigating solutions (NaOCl, saline, EDTA, etidronic acid-HEBP). Material and Methods: One hundred and nine patients were included in this study and were randomly assigned into four groups according to the irrigation solution used; NaOCl, EDTA, HEBF and saline. Electronic MF (EMF) and AC (EAC) were measured by using Raypex 6. The teeth were extracted. The apical 3 mm of each canal was trimmed to expose the file tip. The samples were observed under a stereomicroscope, and the actual length of MF (ALMF) and AC (ALAC) were measured. The data were analyzed by using x2 test, and significance was set at P< 0.05. Results: The Raypex 6 was accurate 71.4% of the time to ±0.5mm and 93.3% of the time to ±1mm in determining the ALAC. While similar ALAC-EAC differences were observed in EDTA, NaOCl, and saline groups (p= 0.230), the highest differences were seen in the HEBP group (p= 1.000). The precision of Raypex 6 in determining the working length measurement depends on the type of irrigation. All solutions allowed reliable detection of AC. However, HEBF significantly increased the risk of overpreparation. Conclusions: Raypex 6 can be recommended for clinical use and its accuracy is not affected by the type of irrigant when locating MF.

Influence of Apical Patency, Coronal Preflaring and Calcium Hydroxide on the Accuracy of Root ZX Apex Locator for Working Length Determination: An In Vitro Study

Aim:

One of the main steps in a successful endodontic treatment is determining the correct working length (WL) of the root canal. In this regard, electronic apex locators (EAL) have been widely used for measuring the WL. The accuracy of EALs in determining the WL may be influenced by various factors. This study is aimed to evaluate the effects of apical patency, coronal preflaring, and calcium hydroxide on the accuracy of the EAL.

Materials and Methods:

In this in vitro study, 20 central incisor single-rooted human teeth with fully formed apex were considered. Then, samples were randomly divided into two study groups, ten samples in each group. The WL was determined and recorded at 0.5 mm distance to the apex using Root ZX apex locator before and after creating patency, coronal preflaring, and calcium hydroxide administration. All WLs were measured separately for each tooth and reviewed independently by two experienced operators with extensive experience in using EALs. Paired t test and Wilcoxon signed-rank test were applied and the significant level was at .05.

Results:

Statistical analysis of the obtained data showed a significant decline in the WL after apical patency and coronal preflaring ( P < .05). Moreover, WL exhibited a significant enhancement after calcium hydroxide application ( P < .05).

Conclusion:

Apical patency and coronal preflaring increased the accuracy of apex locators in determining the WL of the teeth. Besides, calcium hydroxide residues in the root canal reduced the accuracy of the apex locator.

The accuracy of two electronic apex locators on effect of preflaring and file size: An in vitro study

Aim:

This study was conducted to evaluate the effect of preflaring and file size on the accuracy of the Root ZX and E-PEX Pro electronic apex locators (EALs).

Materials and Methods:

The actual working length was set 1 mm short of the apical foramen in the forty extracted mandibular premolars. The teeth were embedded in an alginate mold, and two examiners performed the electronic measurements using #10, #15, and #20 K-files. The files were inserted into the root canals until the “0.0” or “APEX” signals were observed on the light-emitting diode or display screens for the E-PEX Pro and Root ZX, respectively, retracting to the 1.0 mark. The measurements were repeated after the preflaring using the S1 and SX Pro-Taper instruments. The mean differences between the actual length and electronic length values were analyzed by the Wilcoxon signed-ranked test with a significance level of P < 0.05. The factors evaluated were “Accuracy of EALs,” “size of file,” and “presence of preflaring.

Results:

No significant differences were observed in the accuracy of both EALs when compared with the actual lengths. On the size of the file, significant difference noticed with #20 K-file. The preflaring procedure significantly (P < 0.05) increased the accuracy of the measurements for the Root ZX and Epex Pro.

Conclusions:

The tested EALs showed acceptable accuracy, whereas the preflaring procedure revealed a more significant effect than the used file size.

Comparative evaluation of root ZX Mini® apex locator and radiovisiography in determining the working length of primary molars: An In Vivo study

INTRODUCTION

Working length determination is a crucial step for success of pulpectomy. Various new modalities have been developed. The newest technology includes EAL. Electronic apex locators require less chair side time, do not produce pain and avoid unnecessary radiation which makes it more superior in paediatric endodontic procedures.

AIM

To evaluate and compare Root ZX mini apex locator and Radiovisiography (RVG) for determining working length in primary molars.

MATERIALS AND METHODS

A sample of 30 primary molar teeth was subjected to working length determination by Root ZX mini and RVG. The data was collected and then tabulated and subjected to statistical analysis.

RESULTS

On comparison among two groups, it was found there was no difference between the efficiency of modalities. A positive correlation was seen among Root ZX mini and RVG (ICC ​= ​0.99).

CONCLUSION

Root ZX mini and radiovisiography are seen to be precise in determination of working length in primary molars. It can be said that Root ZX mini i. e the electronic apex locators can be used as an adjunct to Radiovisiography and conventional radiography.

Efficiency of an Integrated Apex Locator in Determining Working Length in Various Irrigating Solutions: An In Vivo Study

OBJECTIVES

The objective of this in vivo study was to compare and evaluate the accuracy of VDW Gold (VDW, Munich, Germany) integrated apex locator (IAL) and Root ZX Mini (J. Morita Corp., Kyoto, Japan) in two different irrigating solutions.

MATERIALS AND METHODS

Forty patients who required extraction were included in the study. Following local anesthesia, access opening was performed under rubber dam isolation. Initial negotiation of canal was performed using size 10 K-Files (M-Access, Dentsply Maillefer, Ballaigues, Switzerland). Cervical preparation was carried out using Rotary ProTaper SX files (Dentsply Maillefer, Ballaigues, Switzerland) under copious irrigation with 3% sodium hypochlorite. Patients were divided into two groups of 20 each: Group I (NaOCl) and Group II (CHX). The working length (WL) was determined in triplicates for each tooth using Root ZX apex locator and with S1 ProTaper rotary file in continuous motion in case of VDW Gold IAL in the presence of 3% sodium hypochlorite and 2% chlorhexidine. Therapeutic extraction was performed and WL was determined using size 15 K-Files under 20× magnification.

RESULTS

The paired sample independent t test showed that there was no significant difference between the Root ZX and VDW apex locator in determining the minor foramen in NaOCl group (P = 0.234, 0.453 respectively) and CHX group (P = 0.085, 0.087) when compared with actual working length.

CONCLUSION

Both the apex locators were equally effective in determining WL at 0.5 mm from the apex in presence of irrigating solutions, that is, NaOCl and chlorhexidine.

Evaluation of the accuracy of electronic apex locators, cone-beam computed tomography, and radiovisiography in primary teeth: An in vitro study

Electronic apex locators (EALs), cone-beam computed tomography (CBCT), and radiovisiography (RVG) claim to determine of working length (WL) in primary molar teeth. To evaluate the accuracy of WL determination by using three EALs, RVG, and CBCT imaging in extracted human primary molar teeth with/without root resorption. Twenty extracted primary molar teeth with resorption and 20 extracted primary molar teeth without resorption were used. After measuring actual lengths (AL) (Group 1), the electronic WL measurements were performed by using three different EALs [COXO C Smart-1 Pro (Group 2), iPex (Group 3), and Apex ID (Group 4)]. Two different image sets were obtained as follows: CBCT imaging (Group 5) and RVG (Group 6). AL measurements performed with an endodontic measuring ruler and compared with the EAL, CBCT, and RVG image measurements. For all groups, there were no significant differences between the teeth with resorption and without. There were no significant differences in measuring methods from AL and between the methods used (p > .05). When electronic and radiographic method were compared in different frequency ranges, there was no statistically significant difference (p > .05). This study showed that EALs, CBCT, and RVG have high accuracy in primary molar teeth both with resorption and without root resorption and can be used for determining WL.

Comparison of Accuracy in Determining the Root Canal Working Length by Using Two Generations of Apex Locators - An In Vitro Study

AIM

The present in-vitro study aims to compare the accuracy of root canal working length determination between the third generation and fourth generation electronic apex locators.

MATERIAL AND METHODS

Fifty extracted single-rooted single canal teeth were selected for the study, and a definite coronal plane was prepared. Actual working length (AL) was measured using a stereomicroscope under 8X magnification. Electronic working length measurements were recorded using Root ZX (EL1) and Elements Diagnostic Unit (EL2) apex locators. One-way ANOVA test was carried out to analyse the data among the experimental groups.

RESULTS

The results of the one-way ANOVA test showed that difference in the working length determined by either apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant. The independent 't' test comparing between groups EL1 and AL; and EL2 and AL showed that working length determined by either of the apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant.

CONCLUSION

In this in vitro study, the Root ZX and Elements Diagnostic Unit apex locators are equally accurate for determination of working length when compared to actual working length.

Comparative evaluation of apical constriction position in incisor and molar teeth: An in vitro study

Objective:

The apical constriction (AC) and the apical foramen (AF) are the principal reference points used to determine the apical limit for instrumentation and root canal filling. AC varies in different races, and the aim of the current study was to measure and compare the distances from AC to AF and the anatomical apex (AA) in incisor and molar teeth in the Iranian population.

Materials and Methods:

Forty-five roots of incisor teeth and 45 roots of molar teeth were selected randomly in Isfahan Province, Iran. If the foramen was located toward the mesial or distal side of the apex, the cut was made mesiodistally, and if it was toward the buccal or lingual side, the section was made accordingly. Roots were examined under a microscope at ×25 magnification. The distances from AC to AF and AA were then estimated using a Motic camera. Descriptive statistics were used. The independent t-test was also used to compare distances in incisors and molars, and P = 0.05 was deemed to indicate statistical significance.

Results:

The mean distances between AC and AF were 0.847 ± 0.33 mm in incisors and 0.709 ± 0.27 mm in molars. The mean distances between AC and AA were 1.23 ± 0.39 mm in incisors and 1.01 ± 0.38 mm in molars. In an independent t-test, the distances between AC and AF differed significantly in incisors and molars (P = 0.035), but the distances between AC and AA did not (P = 0.172).

Conclusion:

The end points for root canal therapy should be 0.85 mm in incisors and 0.70 mm in molars.

Accuracy and consistency of electronic root canal length determination with electrically isolating rubber stoppers

The aim of this study was to investigate the influence of an isolating silicone stopper on the measuring accuracy and display consistency of three electrometric apex locators. The length of the canal to the major foramen was determined electrometrically using an ISO size 10 file in 20 extracted teeth each with natural crowns (Group I), amalgam fillings (Group II) or base-metal crowns (Group III), The measurements were performed with isolating or conventional silicone stoppers using three different apex locators with a four-level scale consistency rating. The use of isolating stoppers resulted in a more consistent display than with conventional stoppers, independent of the presence or type of coronal restoration (P = 0.017). Across all coronal restorations, the position of the major foramen could be determined to within ± 0.5 mm without significant differences (P = 0.79) using conventional and isolating stoppers. The use of modified isolating stoppers provides a significant increase in display consistency.

Comparison of Digital Radiography, Conventional Film and Self-Developing Film for Working Length Determination

INTRODUCTION

Accurate measurement of working length of the root canal is an important factor in endodontic treatment, because it determines the level of cleaning and shaping of the canal. This can be performed using numerous methods including conventional, digital and self-developing methods, which are studied in this work.

METHODS AND MATERIALS

In this study, 50 maxillary molars with appropriate conditions for the analysis were collected and their mesiobuccal canal lengths were estimated by three different types of radiographs with and without file. Next, two endodontists and a radiologist reviewed all the images under the same conditions. The precise lengths of the canals were measured by removing teeth from their casts and direct observation. Finally, data regarding differences in radiographic length and actual length were examined by SPSS 16.0 software and Repeated Measures ANOVA test.

RESULTS

There was no significant difference in any of the radiographic states. The differences of root canal lengths were not significant for the first (endodontist) and third (endodontist) observers; whereas, there were significant differences for the second observer (radiologist). The differences were not significant for samples without files (P=0.89). However, the differences were significant for samples with files (P=0.03).

CONCLUSION

Since analysis showed that there were no significant differences between the results of digital radiography, conventional film and self-developing film methods in working length determination, the clinician can choose any of these methods according to the working conditions without being concerned about losing the accuracy.

Can active signals of cellphone interfere with electronic working length determination of a root canal in a dental clinic? An in vivo study

Objective:

To evaluate the interference of active cellphones during electronic working length (EWL) determination of a root canal.

Materials and Methods:

Thirty patients requiring root canal treatment in the anterior teeth or premolars having single canal and mature apices were selected for this study. Working length determination was done using no. 15 K-file. Electronic apex locators ProPex Pixi and Root ZX mini were used for working length determination. Cellphones iPhone 6s and Xolo Q3000 were evaluated for their interference. The experiment was conducted in a closed room (9 feet × 9 feet). Working length was measured with no cellphone in the room, iPhone 6s in a calling mode, Xolo Q3000 in a calling mode, and Xolo Q3000 and iPhone 6s simultaneously in a calling mode. Stability of the readings was also determined for every condition.

Statistical Analysis:

The data were statistically analyzed using one-way ANOVA and paired t-test at 0.05 level of significance.

Results:

Results were not statistically significant.

Conclusion:

Within the limitations of the present study, cellphones do not interfere with the EWL determination.

Influence of Root Canal Curvature on the Accuracy of Root ZX Electronic Foramen Locator: An In Vitro Study

Introduction:

The aim of this in vitro study was to evaluate the correlation between accuracy of Root ZX electronic foramen locator and root canal curvature.

Methods and Materials:

One hundred and ten extracted mandibular molars were selected. Access cavity was prepared and coronal enlargement of mesiobuccal canal was performed. A #10 Flexofile was inserted into the mesiobuccal canal, and a radiography was taken to measure the degree of curvature by Schneider's method. The actual working length (AWL) was defined by inserting the file until its tip could be observed at a place tangential to the major apical foramen and then 0.5 mm was subtracted from this measurement. For the electronic working length (EWL) measurement, the apical 3 or 4 mm of the root was embedded in alginate as the electrolyte material. The file was inserted into the root canal to the major foramen, until the APEX reading was shown on the electronic device and then pulled back until the visual display showed the 0.5-mm mark. The AWL was subtracted from the EWL to define the distance between the file tip and the point 0.5 mm coronal to the major apical foramen. Data were analyzed using the Pearson’s correlation coefficient.

Results:

The accuracy of Root ZX within ±0.1 mm and ±0.5 mm was 38.2% and 94.6%, respectively. There was no correlation between the distance from the EWL to the AWL and the degree of root canal curvature (r=0.097, P=0.317).

Conclusion:

Root canal curvature did not influence the accuracy of Root ZX foramen locator.

An Invitro Evaluation of the Accuracy of Two Electronic Apex Locators to Determine Working Length in the Presence of Various Irrigants

Background

Cleaning and shaping of root canal system requires various irrigating solutions. The question is whether the presence of irrigation solution alters working length determination using apex locators. The purpose of this study was to compare the accuracy of Root ZX and i-Root apex locator for determining working length in the presence of different irrigating solution.

Materials and Method

Eighty extracted single rooted human teeth were used. The teeth were sectioned at Cemento Enamel Junction (CEJ) and actual canal length determined. Then, working length measurements were obtained using Root ZX and i-Root apex locator in the presence of irrigating solutions namely 0.9% saline, 3% of sodium hypochlorite (NaOCl), 2% chlorhexidine digluconate(CHX) and 17% Ethylene Diamine Tetra Acetic acid (EDTA). The measurements obtained with Root ZX and i-Root apex locator were compared with actual canal length and subjected to statistical analysis using Post Hoc Test Tukey's Method.

Results

This study revealed that both the tested Electronic apex locators (EAL) were able to measure the canal length in the presence of tested irrigating solutions. The presence of irrigating solutions of saline, NaOCl, chlorhexidine and EDTA in the root canal marginally influenced the accuracy of the Root ZX or i-Root (P < 0.36), but with no clinical significance.

Conclusion

Root ZX and i-Root can be used safely to determine working length in the presence of various irrigants. The content of the root canal did not influence the accuracy while measuring working length using Electronic apex locators (EAL)

A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study

Aims

The purpose of this study was to evaluate the accuracy of a new-generation electronic apex locator (iPex) to determine working length in primary teeth with or without root resorption as compared with the conventional radiographic method.

Materials and methods

A sample of 30 primary posterior teeth which are indicated for pulpectomy were selected for the study. After obtaining the informed consent from the parents, local anesthesia was administered. Access cavity was prepared with no.10 round bur. Initial exploration of the canals was done with no.10 K-file. Pulp was extirpated with a barbed broach followed by thorough irrigation of the canals with 0.9% saline. Initially, working length was obtained with iPex (new-generation by Nakanishi International) apex locator using no.10 K-file, which was then compared with conventional radiographic method (Ingle’s method).

Results

A total of 65 canals were available for the measurement. The data were analyzed using Statistical Analysis system and t-tests were carried out. There was no statistically significant difference found when using iPex apex locator for working length determination as compared with that of conventional radiographic method (p = 0.511).

Conclusion

Working length determined by iPex apex locator is comparable with that of conventional radiographic method, hence, can be used as an alternative in determining the working length of primary teeth.

How to cite this article

Bhat KV, Shetty P, Anandakrishna L. A Comparative Evaluation of Accuracy of New-generation Electronic Apex Locator with Conventional Radiography to determine Working Length in Primary Teeth: An in vivo Study. Int J Clin Pediatr Dent 2017;10(1):34-36.

Influence of Blood on the Accuracy of Raypex 5 and Root ZX Electronic Foramen Locators: An In Vivo Study

Abstract The aim of this study was to evaluate in vivo the accuracy of the Raypex 5 and Root ZX electronic foramen locators (EFLs) in the presence of blood in the root canal space. Forty single-canal teeth scheduled for extraction were selected. Access cavity was prepared and coronal enlargement was carried out. Approximately two drops of blood were collected by finger prick and injected into the root canal space. The electronic working length (EWL) of each tooth by each device was established twice before (NB group) and after (WB group) injecting blood into the root canal. The tooth was extracted and the actual working length (AWL) was determined. Data were analyzed using McNemar's test. The accuracy rates of Raypex 5 and Root ZX within 0.5 mm in the NB group were 88.9% and 91.5%, with 83.3% and 86.2% in the WB group, respectively. There were no significant differences between the accuracy of each EFL in the two groups (p>0.05). Considering the NB and WB groups, there were no statistically significant differences in the accuracy of the EFLs (p>0.05). The presence of blood in the root canal space did not influence the accuracy of the EFLs.

Working Length Determination Using Cone-Beam Computed Tomography, Periapical Radiography and Electronic Apex Locator in Teeth with Apical Periodontitis: A Clinical Study

Introduction:

The purpose of this clinical study was to compare the accuracy of working length (WL) determination using cone-beam computed tomography (CBCT), conventional periapical radiographies and electronic apex locator.

Methods and Materials:

This study was conducted during root canal treatment of 19 patients with a total of 30 single-rooted teeth diagnosed with apical periodontitis. After taking the initial parallel periapical radiographies, the initial file was advanced into the canal until the WL was detected by the apex locator. Subsequently, the WL was measured and WL radiographies were taken with the file set in the canal. Afterwards, CBCT images were acquired. These three measurements were tabulated and compared and the data were analyzed using the Friedman test. The level of significance was set at 0.05.

Results:

The mean values for WL determination by electronic apex locator, periapical radiograph and CBCT images were 22.25, 22.43 and 22.65, respectively which was not statistically significant (P>0.05).

Conclusion:

Working length determination using CBCT images was precise when compared to radiographic method and electronic apex locator.

An in vitro evaluation of the accuracy of four electronic apex locators using stainless-steel and nickel-titanium hand files

Objectives

The purpose of this in vitro study was to evaluate the accuracy of working length (WL) determination of four electronic apex locators (EALs), namely, Root ZX (RZX), Elements diagnostic unit and apex locator (ELE), SybronEndo Mini Apex locator (MINI) and Propex pixi (PIXI) using Stainless steel (SS) and nickel-titanium (NiTi) hand files. The null hypothesis was that there was no difference between canal length determination by SS and NiTi files of 4 EALs.

Materials and Methods

Sixty extracted, single rooted human teeth were decoronated and the canal orifice flared. The actual length (AL) was assessed visually, and the teeth were embedded in an alginate model. The electronic length (EL) measurements were recorded with all four EALs using SS and NiTi files at '0.5' reading on display. The differences between the AL and EL were compared.

Results

The results obtained with each EAL with SS and NiTi files were compared with AL. A paired sample t test showed that there was a statistical significant difference between EAL readings with SS and NiTi files for RZX and MINI (p < 0.05). The accuracy of RZX, ELE, MINI and PIXI within ± 0.5 mm of AL with SS/NiTi files were 93.3%/70%, 90%/91.7%, 95%/68.3%, and 83.3%/83.3%, respectively.

Conclusions

The results of this study indicate that Root ZX was statistically more accurate with NiTi files compared to SS files, while MINI was statistically more accurate with SS files compared to NiTi files. ELE and PIXI were not affected by the alloy type of the file used to determine WL.

Evaluation of Interference of Cellular Phones on Electronic Apex Locators: An In Vitro Study

INTRODUCTION

Use of mobile phone has been prohibited in many hospitals to prevent interference with medical devices. Electromagnetic radiation emitted from cellular phones might interfere with electronic working length determination. The purpose of this in vitro study was to evaluate the effect of a smart phone (Samsung Galaxy Note Edge) on working length determination of electronic apex locators (EALs) Propex II and Rootor.

METHODS

Fifteen intact, non-carious single-rooted teeth were decoronated at the cementoenamel junction. Visually, working length was determined by using a #15 K-file under stereomicroscope (×20). The effect of cellular phones on electronic working length (EWL) was determined under 2 experimental settings: (1) in a closed room with poor signal strength and (2) in a polyclinic set up with good signal strength and 5 conditions: (1) electronically, without cellular phone in room; (2) electronically, with cellular phone in physical contact with EAL; (3) electronically, with mobile phone in physical contact with EAL and in calling mode for a period of 25 seconds; (4) electronically, mobile phone placed at a distance of 40 cm from the EAL; and (5) electronically, mobile phone placed at a distance of 40 cm and in calling mode for a period of 25 seconds. The EWL was measured 3 times per tooth under each condition. Stability of the readings was scored from 1 to 3: (1) good stability, (2) stable reading after 1 attempt, and (3) stable reading after 2 attempts. The data were compared by using analysis of variance.

RESULTS

The EWL measurements were not influenced by the presence of cellular phone and could be determined under all experimental conditions.

CONCLUSIONS

Within the limitations of this study, it can be concluded that mobile phones do not interfere with the EWL determination.

Endodontics and the ageing patient

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient.

Comparison of third generation versus fourth generation electronic apex locators in detecting apical constriction: An in vivo study

AIM

The aim of this in vivo study was to compare the accuracy of Root ZX and Raypex 5 in detecting minor diameter in human permanent single-rooted teeth.

MATERIALS AND METHODS

Thirty-one patients with completely formed single-rooted permanent teeth indicated for extraction were selected for the study. Crown was flattened for stable reference point and access cavity prepared. Working length was determined with both apex locators. A 15 K file adjusted to that reading was placed in the root canal and stabilized with cement. The tooth was then extracted atraumatically. Following extraction apical 4 mm of root was shaved. The position of the minor diameter in relation to the anatomic apex was recorded for each tooth under stereomicroscope at ×10. The efficiency of two electronic apex locators to determine the minor diameter was statistically analyzed using paired sample t-test.

RESULTS

The minor diameter was located within the limits of ±0.5 mm in 96.6% of the samples with the Root ZX and 93.2% of the samples with Raypex 5. The paired sample t-test showed no significant difference.

CONCLUSION

On analyzing the results of our study it can be concluded that Raypex 5 was as effective as Root ZX in determining the minor diameter.

Evaluation of electrical impedance ratio measurements in accuracy of electronic apex locators

Objectives

The aim of this paper was evaluating the ratios of electrical impedance measurements reported in previous studies through a correlation analysis in order to explicit it as the contributing factor to the accuracy of electronic apex locator (EAL).

Materials and Methods

The literature regarding electrical property measurements of EALs was screened using Medline and Embase. All data acquired were plotted to identify correlations between impedance and log-scaled frequency. The accuracy of the impedance ratio method used to detect the apical constriction (APC) in most EALs was evaluated using linear ramp function fitting. Changes of impedance ratios for various frequencies were evaluated for a variety of file positions.

Results

Among the ten papers selected in the search process, the first-order equations between log-scaled frequency and impedance were in the negative direction. When the model for the ratios was assumed to be a linear ramp function, the ratio values decreased if the file went deeper and the average ratio values of the left and right horizontal zones were significantly different in 8 out of 9 studies. The APC was located within the interval of linear relation between the left and right horizontal zones of the linear ramp model.

Conclusions

Using the ratio method, the APC was located within a linear interval. Therefore, using the impedance ratio between electrical impedance measurements at different frequencies was a robust method for detection of the APC.

Influence of tooth length on the accuracy of the Root ZX electronic apical foramen locator: an ex vivo study

OBJECTIVE

Electronic apical foramen locators are now widely used to determine working length. This study was designed to determine whether tooth length influenced the accuracy of the Root ZX device.

MATERIALS AND METHODS

Forty extracted maxillary canine teeth with a length range of 27-29 mm were selected. Access cavities were prepared and coronal flaring of canals performed. The teeth were mounted in self-polymerizing acrylic resin to facilitate horizontal sectioning except for the apical 3-4-mm portion of the root and embedded in alginate as the electronic medium. Electronic measurements were taken at the major foramen, 'zero' reading using the Root ZX and compared with the actual root canal length. The teeth were sectioned 3 mm from the coronal reference point to create a second group with shorter length; these reductions in the length continued six times in all to create seven groups of 40 specimens each. The actual and electronic lengths of specimens in each group were measured. Data were analyzed by Pearson's correlation coefficient.

RESULTS

Identical measurements between the actual and electronic root canal length from the longest to the shortest groups were 12.5%, 10.0%, 20.0%, 27.5%, 37.5%, 35.0% and 45.0%, respectively. There was a mild negative correlation between the precise measurements of the Root ZX and root canal lengths in the seven groups (r = -0.964, p < 0.001).

CONCLUSION

Under the conditions of the study, the Root ZX device was more accurate in shorter teeth compared to longer ones.

Comparative evaluation of accuracy of 2 electronic Apex locators with conventional radiography: an ex vivo study

INTRODUCTION

The aim of this ex vivo study was to evaluate the accuracy of the Raypex 5 (VDW, Munich, Germany) and Apex NRG XFR (Medic NRG Ltd, Tel Aviv, Israel) electronic apex locators (EALs) in determining the working length when compared with radiographs.

METHODS

Twenty-five human single-rooted teeth were selected, and the access cavity was prepared. The working length (WL) was determined radiographically and electronically by using 2 EALs. The files were fixed at the WL, and the teeth were extracted. The apical 4 mm of each canal was trimmed to expose the file tip, and the samples were observed under a stereomicroscope. The distance from the file tip to the point 0.5 mm coronal to the anatomic apex was measured. The data were analyzed by using 1-way analysis of variance and the Tukey Honestly Significant Difference test.

RESULTS

There was no significant difference between the Raypex 5 and the Apex NRG XFR devices with respect to their accuracy in determining the final WL. When compared with radiography, both the EALs had no significant difference. When comparing EALs and radiographic measurements with control measurements, accuracy results were found to be 20%, 36%, and 52% for the Raypex 5, Apex NRG XFR, and radiography, respectively. Overestimations of WL determination by the Raypex 5, Apex NRG XFR, and radiography were 4%, 0%, and 40%, respectively. Underestimations of WL determination by the Raypex 5, Apex NRG XFR, and radiography were 76%, 64%, and 8%, respectively.

CONCLUSIONS

Both the EALs had the same accuracy in determining the WL when compared with radiography.

In vivo evaluation of the accuracy of working length determination using an electronic apex locater IPEX (NSK) on vital uninfected teeth and teeth with radiographic evidence of periapical lesions

AIM

To evaluate the accuracy of working length determination of an electronic apex locator, IPEX, on vital uninfected teeth and teeth with radiographic evidence of periapical lesions.

MATERIALS AND METHODS

Twenty vital and uninfected teeth and 16 teeth with a single canal and matured apices and having radiographic evidence of periapical lesions of 5-10 mm were taken for this study. Access cavities were prepared and pulp was considered to be vital if bleeding was present upon entering the chambers. No. 15 k-type file was used to determine the working length. X-rays were taken to determine the working length using Ingle's method, followed by determination using the electronic apex locator, IPEX. Teeth were then observed under 45 × magnification using stereomicroscope. No 15 k-type file was maneuvered till the emergence of the tip was seen and the real length of the tooth was thus measured in the instrument up to 0.5 mm accuracy using stereomicroscope.

RESULTS

The data were duly collected and entered, and the statistical analysis was done using Student's t test. In uninfected teeth, IPEX was found to be more reliable than Ingle's radiographic technique, but this was not statistically significant. In case of teeth with radiographic evidence of periapical lesions, the radiographic method appeared to be relatively more dependable; however, this difference was not statistically significant.

CONCLUSION

For rendering effective root canal procedure, both radiographs and electronic apex locators have important roles to play.

Working Length Determination of Root Canal of Young Permanent Tooth: An In vitro Study

BACKGROUND

Determination of correct working length is one of the keys to success in endodontic therapy.

AIM

The aim of this study was to evaluate the diagnostic efficacy of various methods to determine working length of root canal.

MATERIALS AND METHODS

Tactile method was assessed using digital radiography and compared with electronic method using apex locator. A total sample of 30 single rooted young permanent teeth the (mandibular first premolars) with matured apices were selected for the study. Access cavity preparation was carried out. Working length was measured by tactile method using digital radiography and electronic method using apex locator with no 15 K file. Actual working length was established by grinding of cementum and dentine from the root apex and was observed under stereomicroscope. Data was collected and statistical analysis was carried out with the help of SPSS-15.

RESULTS

The results of this study showed that there was a significant difference between tactile method assessed by digital radiography and electronic method using apex locator.

CONCLUSION

Apex locator was found to be more reliable and accurate when compared with the actual length.

Clinical efficacy of electronic apex locators: systematic review

INTRODUCTION

Apical constriction has been proposed as the most appropriate apical limit for the endodontic working length. Despite being the most used, some limitations are attributed to the radiographic method of working length determination. It lacks precision because it is based on the average position of the apical constriction. The electronic apex locators have been presented as an alternative to the odontometry performed by radiography. These devices detect the transition of the pulp to the periodontal tissue, which is anatomically very close to the apical constriction and may perform with improved accuracy.

METHODS

A systematic review was performed to compare the radiographic and electronic methods. Clinical studies that compared both methods were searched for on 7 electronic databases, a manual search was performed on the bibliography of articles collected on the electronic databases, and the authors were contacted to ask for references of more research not detected on the electronic and manual search.

RESULTS

Twenty-one articles were selected. The majority were comparative or evaluation studies, and very few clinical studies comparing both methods are available. Several methodological limitations are present on the collected articles and debated in this review.

CONCLUSIONS

Although the available scientific evidence base is short and at considerable risk of bias, it is still possible to conclude that the apical locator reduces the patient radiation exposure and also that the electronic method may perform better on the working length determination. At least one radiographic control should be performed to detect possible errors of the electronic devices.

Ex vivo accuracy of Root ZX II, Root ZX Mini and RomiApex A-15 apex locators in extracted vital pulp teeth

The objective of this study was to compare, ex vivo, the accuracy of three electronic apex locators (EALs), Root ZX II, Root ZX Mini and RomiApex A-15, in detecting the apical foramen (AF). Forty extracted single-Rooted human teeth with vital pulp were used in this study. After access preparation, the Root canal length of each tooth was measured by placing a #10 file until the tip was visible at the AF under a stereomicroscope. The teeth were subsequently embedded in an alginate model. In each Root canal, all three EALs were used to determine the working length, which was defined as the zero reading or equivalent. The distance between the file tip and AF was measured to an accuracy of 0.01 mm. Results were analyzed using analysis of variance and the Chi-squared test. Root ZX II, Root ZX Mini and RomiApex A-15 were accurate within 0.5 mm, 62.5, 56.2, 50% of the time. No significant differences were found between the three EALs (p > 0.05). Considering all EALs, the mean distance from the file tip to AF was 4.49 mm. The accuracy of the three EALs evaluated in this study was not statistically significantly different. The 'Apex' or '0.0' marks of the EALs do not indicate the AF itself, but just a position coronal 0.49 mm to the AF. Using a tolerance of ± 0.5 mm from the actual lengths, the ZX II yielded the most acceptable measurements.

A comparative assessment of the accuracy of electronic apex locator (Root ZX) in the presence of commonly used irrigating solutions

Objectives: This study aimed to evaluate the accuracy of Root ZX in determining working length in presence of normal saline, 0.2% chlorhexidine and 2.5% of sodium hypochlorite. Material and Methods: Sixty extracted, single rooted, single canal human teeth were used. Teeth were decoronated at CEJ and actual canal length determined. Then working length measurements were obtained with Root ZX in presence of normal saline 0.9%, 0.2% chlorhexidine and 2.5% NaOCl. The working length obtained with Root ZX were compared with actual canal length and subjected to statistical analysis. Results: No statistical significant difference was found between actual canal length and Root ZX measurements in presence of normal saline and 0.2% chlorhexidine. Highly statistical difference was found between actual canal length and Root ZX measurements in presence of 2.5% of NaOCl, however all the measurements were within the clinically acceptable range of ±0.5mm. Conclusion: The accuracy of EL measurement of Root ZX within±0.5 mm of AL was consistently high in the presence of 0.2% chlorhexidine, normal saline and 2.5% sodium hypochlorite. Clinical significance: This study signifies the efficacy of ROOT ZX (Third generation apex locator) as a dependable aid in endodontic working length.

Key words:Electronic apex locator, working length, root ZX accuracy, intracanal irrigating solutions.

Influence of apical periodontitis on the accuracy of 3 electronic root canal length measurement devices: an in vivo study

INTRODUCTION

The aim of this in vivo study was to evaluate the influence of apical periodontitis (AP) on the accuracy of Dentaport ZX (J Morita, Kyoto, Japan), Raypex 5 (VDW, Munich, Germany), and i-Root (S-Denti, Seoul, Korea) electronic root canal length measurement devices (ERCLMDs).

METHODS

Thirty-two single-rooted teeth scheduled for extraction, consisting of 16 teeth with AP and 16 teeth with normal periapex (NP), were selected. The access cavity was prepared, and the coronal portion of the canal was flared. The electronic working length (EWL) was determined by each ERCLMD according to each manufacturer's instructions. Each tooth was extracted, and the actual working length (AWL) was determined by inserting a size 15 K-file until the tip could be seen at a position tangential to the major foramen and then 0.5 mm was subtracted from the measurement. The distance from the file tip (EWL) to the point 0.5 mm coronal to the major foramen (AWL) was calculated. Data were analyzed using the nonparametric Fisher exact test and the chi-square test. Statistical significance was set at P < .05.

RESULTS

The accuracies of Dentaport ZX, Raypex 5, and i-Root within ± 0.5 mm in the AP group were 93.8%, 81.3%, and 75.0%; they were 93.3%, 86.7%, and 73.3% in the NP group, respectively. There were no significant differences between the accuracy of each device in the 2 groups (P > .05). Considering the 2 groups of AP and NP, there were no statistically significant differences in the accuracy of the ERCLMDs (P > .05).

CONCLUSIONS

The presence of AP did not influence the accuracy of ERCLMDs.

An in vivo evaluation of different methods of working length determination

OBJECTIVE

The purpose of this in vivo study was to compare the ability of digital tactile, digital radiographic and electronic methods to determine reliability in locating the apical constriction.

MATERIALS AND METHODS

Informed consent was obtained from patients scheduled for orthodontic extraction. The teeth were anesthetized, isolated and accessed. The canals were negotiated, pulp chamber and canals were irrigated and pulp was extirpated. The working length was then evaluated for each canal by digital tactile sensation, an electronic apex locator (The Root ZX) and digital radiography. The readings were then compared with post-extraction working length measurements.

RESULTS

The percentage accuracy indicated that EAL method (Root ZX) shows maximum accuracy, i.e. 99.85% and digital tactile and digital radiographic method (DDR) showed 98.20 and 97.90% accuracy respectively.

CLINICAL SIGNIFICANCE

Hence, it can be concluded that the EAL method (Root ZX) produced most reliable results for determining the accurate working length.

Comparative evaluation of accuracy of two electronic apex locators in the presence of various irrigants: An in vitro study

Context:

The establishment of appropriate working length is one of the most critical steps in endodontic therapy. Electronic apex locators have been introduced to determine the working length. The development of electronic apex locators has helped make the assessment of the working length more accurate and predictable, along with reduction in treatment time and radiation dose.

Objectives:

The aim of this study was to compare the efficacy of electronic apex locators after cleansing and shaping of the root canals and whether there was any alteration in accuracy when used in the presence of irrigants.

Materials and Methods:

Seventy extracted human permanent molars with mature apices were selected. Equal number of maxillary and mandibular permanent molars (35 each) were sectioned at the cemento-enamel junction. Access opening was done and only the mesiobuccal root canal was studied for the purpose of standardization. Electronic working length measurements were taken before and after preparation of the mesiobuccal canal with Root ZX and ProPex II using various irrigants.

Statistical Analysis Used:

The data were statistically analyzed using a paired t-test at 0.05 level of significance.

Results:

P-values for actual and final canal lengths for Root ZX employing NaoCl(0.001), CHX(0.006), LA(0.020) and for ProPex II was (0.001) respectively. When the data were compared, results were statistically significant (P < 0.05).

Conclusion:

Within the limitations of this study Root ZX can be considered to be an accurate electronic apex locator and CHX as irrigant matched more precisely with the actual canal length measurements.

The reliability of artificial neural network in locating minor apical foramen: a cadaver study

INTRODUCTION

The purpose of this study was to evaluate the accuracy of the artificial neural network (ANN) in a human cadaver model in an attempt to simulate the clinical situation of working length determination.

METHODS

Fifty single-rooted teeth were selected from 19 male cadavers ranging in age from 49-73 years. Access cavities were prepared, a file was placed in the canals, and the working length was confirmed radiographically by endodontists. The location of the file in relation to the minor apical foramen was categorized as long, short, and exact by the ANN, by endodontists before extraction, and stereomicroscopically after extraction. The results were compared by using Friedman and Wilcoxon tests. The significance level was set at P <.05.

RESULTS

The Friedman test revealed a significant difference among groups (P < .001). There were significant differences between data obtained from endodontists and ANN (P = .001) and data obtained from endodontists and real measurements by stereomicroscope after extraction (P < .002). The correct assessment by the endodontists was accurate in 76% of the teeth. ANN determined the anatomic position correctly 96% of the time. The confidence interval for the correct result was 64.16-87.84 for endodontists and 90.57-101.43 for ANN.

CONCLUSIONS

ANN was more accurate than endodontists' determinations when compared with real working length measurements by using the stereomicroscope as a gold standard after tooth extraction. The artificial neural network is an accurate method for determining the working length.

Comparison of accuracy of two electronic apex locators in the presence of various irrigants: An in vitro study

AIM

This study was designed to compare the accuracy of Root ZX and SybronEndo Mini, electronic apex locators (EALs), in the presence of various irrigants.

MATERIALS AND METHODS

Sixty extracted, single-rooted human teeth were decoronated and the root canals coronally flared. The actual length (AL) was assessed visually and teeth mounted in the gelatin model. The electronic length (EL) measurements were recorded with both EALs in the presence of 0.9% saline; 1% sodium hypochlorite (NaOCl); 2% chlorhexidine digluconate (CHX), and 17% EDTA solution, at "0.5" reading on display. The differences between the EL and AL were compared.

RESULTS

The accuracy of EL measurement of Root ZX and Sybron Mini within±0.5 mm of AL was consistently high in the presence of NaOCl and found to be least with EDTA.

CONCLUSION

EL measurements were shorter with 1% NaOCl, whereas longer with 2% CHX for both the devices. Sybron Mini was more accurate with 1% NaOCl and 2% CHX than Root ZX.

In vivo accuracy of three electronic root canal length measurement devices: Dentaport ZX, Raypex 5 and ProPex II

AIM

To compare in vivo three different electronic root canal length measurement devices: Dentaport ZX, Raypex 5 and ProPex II.

METHODOLOGY

Thirty single-rooted permanent teeth scheduled for extraction because of periodontal disease were selected from 10 adult patients (ranging from 45 to 67 years) and divided into three groups of 10 teeth. Before the extraction, an access cavity was prepared and the crown was adjusted to establish a stable reference point for all measurements. The working length in Group 1 was determined using the Dentaport ZX apex locator. A K-file with the largest diameter that could reach the last green bar on the screen was stabilized in the canal using a dual-curable flow resin composite. The same procedure was used for the Raypex 5 (the file reached the last yellow bar) and Propex II (0.0 orange bar) apex locators. The teeth were then extracted and cleared. The distance between the tip of the file and the major foramen was then calculated for each tooth using digital photography according to Axiovision AC software (Carl Zeiss). Positive values were assigned when the file tip passed beyond the major foramen, negative values when the tip was short of the foramen and zero value when the file tip and the foramen coincided. Statistical analysis was performed using the chi-squared test or Fisher's exact test (P ≤ 0.05).

RESULTS

  Dentaport ZX, Raypex 5 and ProPex ΙΙ produced, respectively, 6, 2 and 4 out of 10 correct measurements, 0, 6 and 5 long measurements and 4, 2, and 1 short measurements. The differences between the three electronic root canal length measurement devices were not significant (P = 0.507).

CONCLUSIONS

Under the in vivo conditions of this study, the three electronic root canal length measurement devices were not significantly different in terms of locating the major foramen.