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Furlan RD, Alcalde MP, Vivan RR, Klymus ME, Limoeiro AGS, Duarte MAH, de Vasconcelos BC. Influence of Different Apical Foramen Morphologies on the Accuracy of Four Electronic Foramen Locators. Eur J Dent 2024. [PMID: 38698613 DOI: 10.1055/s-0044-1782214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2024] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the accuracy of the Root ZX II (RZX), Raypex 6 (RAY), EPex Pro (EPEX), and CanalPro (CNP) electronic foramen locators (EFLs) in different foraminal morphologies (fully formed foramen, immature foramen with parallel walls, and immature foramen with divergent walls); this article also evaluated the influence of different penetration levels (0.0 mm and -1.0 mm). MATERIALS AND METHODS Thirty single-rooted human premolars were accessed and had their cervical/middle thirds prepared with SX ProTaper files. The apical foramens (AF) were standardized to 250 µm and the initial root canal length (RCL1) was measured under 16x magnification with aid of a digital caliper. Using the alginate model, electronic measurements (EM) were taken 1.0 mm up to AF (EM1/-1) and at AF (EM1/0), always using adjusted hand K-files. The root apexes were then cross-sectioned 3.0 mm from the foramen; then, new RCL (RCL2) and electronic measurements were performed (EM2/-1 and EM2/0.0). Finally, retropreparations were performed with instruments SX ProTaper files introduced 4.0 mm in the apicocervical direction. Then new RCL (RCL3) and electronic measurements (EM3/-1 and EM3/0) were performed. STATISTICAL ANALYSIS Values were tabulated and tested for normality using the Shapiro-Wilk test, which yielded nonparametric distributions of the data. Data were subjected to the Kruskal-Wallis and Dunn tests to estimate possible differences between devices as a function of foramen morphology and/or apical limit. The significance level was set at 5.0%. RESULTS In general, the EFLs were accurate in determining the RCL. Statistically significant differences were observed between EPEX and RAY at 0.0, when measuring the divergent AF canals (p < 0.05). Regarding the different foramen morphologies in each EFL, RZX and EPEX showed no interference (p > 0.05), whereas RAY and CNP had lower accuracy levels at 0.0 with divergent AF (p < 0.05). CONCLUSION The four devices evaluated are accurate to determine the RCL in the conditions tested. The apical limit of penetration did not have significant influence on their accuracy. Conversely, the presence of divergence in the AF walls negatively influenced de RAY and CNP precisions at the foraminal level.
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Affiliation(s)
- Renan D Furlan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Murilo P Alcalde
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Rodrigo R Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Michel E Klymus
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Ana G S Limoeiro
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Marco A H Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, University of São Paulo, Bauru, SP, Brazil
| | - Bruno C de Vasconcelos
- Post-Graduate Program in Dentistry, School of Pharmacy, Dentistry and Nursing, Federal University of Ceará, Fortaleza, Ceará, Brazil
- School of Dentistry of Sobral, Federal University of Ceará, Campus Sobral, Sobral, CE, Brazil
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Monisha R, Sivakumar A, Chittrarasu M, Sampath SJ, Soundappan SP, Benny R. Comparative evaluation of accuracy of working length determination with fifth-generation apex locator using two different techniques: An in vitro study. JOURNAL OF CONSERVATIVE DENTISTRY AND ENDODONTICS 2024; 27:240-245. [PMID: 38634026 PMCID: PMC11019798 DOI: 10.4103/jcde.jcde_210_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/15/2023] [Accepted: 12/05/2023] [Indexed: 04/19/2024]
Abstract
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.
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Affiliation(s)
- R Monisha
- Department of Conservative Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
| | - Andamuthu Sivakumar
- Department of Conservative Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
| | - M Chittrarasu
- Department of Conservative Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
| | - Sivakumar Jambai Sampath
- Department of Conservative Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
| | - Saravana Priyan Soundappan
- Department of Conservative Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
| | - Reveena Benny
- Department of Conservative Dentistry, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
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Koç S, Kuştarcı A, Er K. Accuracy of different electronic apex locators in determination of minimum Root perforation diameter. AUST ENDOD J 2023; 49 Suppl 1:179-186. [PMID: 36354104 DOI: 10.1111/aej.12711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/17/2022] [Accepted: 11/01/2022] [Indexed: 11/11/2022]
Abstract
This study aims to evaluate the ability of Raypex 6, Propex Pixi, Dentaport ZX, Apex ID, Propex II and Dr.'s Finder NEO to detect minimum root canal perforation diameter. One hundred single-rooted, extracted human teeth were artificially perforated by 5 burs in different diameters (0.25-1.25 mm) in 5 mm above the apex. Twenty teeth were assigned to each group. The actual canal lengths (AL) were measured under stereomicroscope followed by a measurement of electronic canal length (EL) using each electronic apex locator (EAL). None of the EALs were able to detect the perforation at diameters of 0.50 and 0.25 mm. Although all EALs used in our study were unable to detect perforations at diameters of 0.5 mm and 0.25 mm, they were highly successful in the determination of simulated root perforations at diameters of 1.25, 1 and 0.75 mm.
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Affiliation(s)
- Simay Koç
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Alper Kuştarcı
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Kürşat Er
- Department of Endodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Cîmpean SI, Chisnoiu RM, Colceriu Burtea AL, Rotaru R, Bud MG, Delean AG, Pop-Ciutrilă IS. In Vitro Evaluation of the Accuracy of Three Electronic Apex Locators Using Different Sodium Hypochlorite Concentrations. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59050918. [PMID: 37241150 DOI: 10.3390/medicina59050918] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023]
Abstract
Background and Objectives: The aim of this study was to compare the accuracy of three types of electronic apex locators (EALs) when two different concentrations of NaOCl irrigation solutions are used by two operators. Materials and Methods: After creating the access cavities for 20 single rooted extracted teeth, the actual canal length (ACL) of each canal was determined visually using a #10 file and magnification. The teeth were subsequently inserted in plastic molds filled with alginate. The electronic measurement of root canal length (EWL) was performed using three different electronic apex locators: Root ZX II, Apex ID, and Dual Pex. Two independent operators, an endodontic specialist with 20 years practice and an undergraduate student in the final year of study, performed the irrigation procedures with two different concentrations of NaOCl (2% and 5.25%), and then measured the EWL using each of the EALs. The accuracy of all EALs, was determined in each case by subtracting the EWL from the ACL. Statistical analyses were performed using one-way ANOVA test. Results: In the presence of 2% NaOCl solution, for a margin error of ±0.5 mm, Root ZX II, Apex ID, and Dual Pex presented an accuracy of 90%, 80%, and 85% respectively. The increase in the concentration of the irrigation solution affected the accuracy of Root ZX II and Apex ID for both operators, diminishing it to 75% for the same margin error, but improved Dual Pex's accuracy to 100%. Conclusions: The best accuracy in working length determination was obtained by Root ZX II for 2% NaOCl solution and by Dual Pex for 5.25% NaOCl solution with no significant statistical difference when compared.
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Affiliation(s)
- Sanda Ileana Cîmpean
- Department of Odontology, Endodontics and Oral Pathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Radu Marcel Chisnoiu
- Department of Odontology, Endodontics and Oral Pathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Adela Loredana Colceriu Burtea
- Department of Odontology, Endodontics and Oral Pathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Rareș Rotaru
- Student at Faculty of Dental Medicine, "Iuliu Hațieganu" University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania
| | - Marius Gheorghe Bud
- Department of Odontology, Endodontics and Oral Pathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Ada Gabriela Delean
- Department of Odontology, Endodontics and Oral Pathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
| | - Ioana-Sofia Pop-Ciutrilă
- Department of Odontology, Endodontics and Oral Pathology, "Iuliu Hațieganu" University of Medicine and Pharmacy, 33 Moților Street, 400001 Cluj-Napoca, Romania
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De-Deus G, Cozer V, Souza EM, Silva EJNL, Belladonna FG, Simões-Carvalho M, Versiani MA. Clinical accuracy and precision of 3 multi-frequency electronic apex locators assessed through micro-CT imaging. J Endod 2023; 49:487-495. [PMID: 36848949 DOI: 10.1016/j.joen.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 02/19/2023] [Indexed: 02/27/2023]
Abstract
INTRODUCTION This study aimed to compare the in vivo accuracy and precision of 3 electronic apex locators (EALs) in determining the position of the major foramen using micro-computed tomographic (micro-CT) technology. METHODS After access preparation of 23 necrotic or vital teeth from 5 patients, canals were negotiated and hand files were used to determine the position of the foramen with 3 EALs: Propex Pixi, Woodpex III and Root ZX II. After fixing the silicon stop to the file, teeth were extracted and scanned in a micro-CT device with and without the instrument inserted into the canal. Datasets were co-registered, and the accuracy and precision of the EALs were determined at a tolerance level of ± 0.5 mm by measuring the distance from the tip of the instruments to a tangential line crossing the margins of the foramen. Statistical comparisons were performed using Friedman with post hoc Related Samples Sign and Spearman tests (α = 5%). RESULTS A significant difference was detected comparing the accuracy of Root ZX II (100%), Woodpex III (86.96%) and Propex Pixi (52.17%) (P < .05). There was a lack of significance in the relationship between the pulp status and the accuracy of tested EALs (P > .05). Propex Pixi was significantly less precise than Root ZX II (P < .05), while no difference was found between Woodpex III to either Root ZX II or Propex Pixi (P > .05). CONCLUSIONS EALs presented similar precision, but Woodpex III and Root ZX II showed better accuracy to determine the position of the apical foramen than Propex Pixi.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Viviany Cozer
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Marco Aurélio Versiani
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil
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De-Deus G, Cozer V, Souza EM, Silva EJNL, Wigler R, Belladonna FG, Simões-Carvalho M, Versiani MA. Micro-CT study of the in vivo accuracy of a wireless electronic apex locator. J Endod 2022; 48:1152-1160. [PMID: 35780927 DOI: 10.1016/j.joen.2022.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION This study aimed to compare the in vivo accuracy of Wirele-X and RootZX II electronic apex locators (EALs) in determining the position of the major foramen using micro-CT as analytical tool. METHODS Eleven vital teeth from 5 patients planned for extraction were used. After conventional access cavity preparation, root canals were flared and negotiated up to the apical third with sizes 08 and 10 K-files followed by irrigation with 2.5% NaOCl. K-type files were used to determine the working length of the selected canals using Root ZX II and Wirele-X apex locators until their numeric displays read '0.0'. After fixing the silicon stop to the file, teeth were extracted and imaged in a micro-CT device using a double-scan protocol. Image stacks, with and without the file in the root canal, were then co-registered and the measurement error calculated as the absolute difference between the tip of the file and the major foramen. Positive and negative values were recorded when the file tip was detected beyond or short the major foramen, respectively. Accuracy was determined on stable measurements within ± 0.5 mm when the file tip did not extend beyond the major foramen. The Chi-square test was applied to compare the ability of the EALs to detect the position of the major foramen, while T test for dependent variables was used to verify differences in the two measurements obtained in each tooth. Significance level was set at 5%. RESULTS Within a tolerance level of ± 0.5 mm, no significant differences were observed between the tested EALs regarding the absolute distance values (p=0.82) or in their ability to detect the position of the major foramen (Χ2=0.2588; p=0.6109). The accuracy of the Root ZX II and the Wirele-X apex locators within ± 0.5 mm were 81.8% and 90.9%, respectively. CONCLUSIONS Root ZX II and Wirele-X performed similarly regarding the in vivo detection of the major foramen. Using strict criteria, the accuracy of the Root ZX II and the Wirele-X apex locators were 81.8% and 90.9%, respectively.
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Affiliation(s)
- Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
| | - Viviany Cozer
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | - Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
| | - Ronald Wigler
- Department of Endodontology, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Marco Aurélio Versiani
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil; Dental Specialty Center, Brazilian Military Police, Minas Gerais, Brazil
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Iparraguirre Nuñovero MF, Piasecki L, Segato AVK, Westphalen VPD, Silva Neto UX, Carneiro E. A laboratory study of the accuracy of three electronic apex locators: influence of embedding media and radiographic assessment of the electronic apical limit. Int Endod J 2021; 54:1200-1206. [PMID: 33683733 DOI: 10.1111/iej.13507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 03/03/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Abstract
AIM To evaluate several factors that might interfere with the use of electronic root canal length measurement devices (ERCLMDs) in a laboratory setting, including two different embedding media (alginate and electroconductive gel), three different types of devices and the radiographic view on the assessment of the electronic readings. METHODOLOGY Thirty single-rooted extracted human mandibular premolars were selected. After access and canal pre-flaring, a size 10 K-file was inserted in the canal up to the major apical foramen under magnification (×10), and this length was recorded as the actual length (AL) of the canal. Teeth were mounted on a specific endodontic training kit platform (ProTrain). Two different embedding media (electroconductive gel and alginate) and three different ERCLMDs: Apex ID (SybronEndo, Glendora, CA, USA), CanalPro Apex Locator (Coltene-Endo, Cuyahoga Falls, OH, USA) and the Root ZX II (J. Morita, Tokyo, Japan), were tested. Following the measurement at the 0.5 mark of each ERCLMD using alginate, two periapical radiographs (bucco-lingual and proximal views) were taken. The difference between the electronic readings and the AL, as well as the distance from the file tip to the apex of the roots on the radiographs, was calculated. Data were analysed statistically (two-way anova, Tukey's and chi-squared tests) at 5% significance level. RESULTS The incidence of over-extended readings was significantly greater (P < 0.05) when using the ProTrain electroconductive gel, except for Root ZX II at the 0.5 mark. Root ZX, CanalPro and Apex ID had similar accuracy when the 0.0/APEX mark was used to locate the foramen. For the radiographic method, no difference was found between the devices or radiographic views. CONCLUSION Compared with alginate, the conductive gel of the ProTrain kit negatively affected most of the electronic readings. The three evaluated ERCLMDs had similar accuracy in locating the apical foramen when using the mark 0.0/APEX and alginate as the embedding media. Although the ProTrain platform allows radiographs to be exposed in both bucco-lingual and proximal views, no difference was found between the views when evaluating the apical limit provided by the 0.5 mark in mandibular premolars embedded in alginate.
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Affiliation(s)
- M F Iparraguirre Nuñovero
- Department of Endodontics, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - L Piasecki
- Department of Periodontics and Endodontics, University at Buffalo, New York, NY, USA
| | - A V K Segato
- Department of Endodontics, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - V P D Westphalen
- Department of Endodontics, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - U X Silva Neto
- Department of Endodontics, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
| | - E Carneiro
- Department of Endodontics, Life Sciences School, Pontifícia Universidade Católica do Paraná, Curitiba, Brazil
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Adorno CG, Solaeche SM, Ferreira IE, Pedrozo A, Escobar PM, Fretes VR. The influence of periapical lesions on the repeatability of two electronic apex locators in vivo. Clin Oral Investig 2021; 25:5239-5245. [PMID: 33580848 DOI: 10.1007/s00784-021-03831-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 02/05/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To determine the influence of periapical lesions on the repeatability of two electronic apex locators (EALs), Root ZX II, and RomiApex A-15, in maxillary anterior teeth, in vivo. MATERIALS AND METHODS After approval by the local ethics committee, 43 maxillary anterior teeth scheduled for root canal therapy were assigned to two groups. The periapical lesion (PAL) group included 21 teeth with necrotic pulps and radiographically visible periapical lesion, and the normal periapex (NPA) group consisted of 22 teeth with vital pulps and no periapical lesion. In each canal, Root ZX II and RomiApex A-15 were used to determine working length defined as the "zero" reading on the display. Two consecutive measurements were performed with each EAL on each tooth and a second operator measured the endodontic file with a digital caliper without knowledge of the EAL being used or the tooth diagnosis. The absolute value of the difference between the first and second measurement (measurement pairs) was calculated. Repeatability was evaluated by the Bland-Altman method, and an aligned ranks transformation ANOVA was conducted to compare the EALs. RESULTS The median absolute difference between measurement pairs was significantly lower (p < 0.001) and the limits of agreement were narrower in the NPA group. Among the EALs, median absolute differences were significantly smaller for Root ZX (p < 0.001). CONCLUSIONS Measurements were more repeatable when no periapical lesion was present. Root ZX showed better repeatability than RomiApex. CLINICAL RELEVANCE Periapical lesions seem to influence successive in vivo measurements with EALs.
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Affiliation(s)
- Carlos G Adorno
- Universidad Nacional de Asunción, Facultad de Odontología, Asunción, Paraguay.
| | - Sandra M Solaeche
- Universidad Nacional de Asunción, Facultad de Odontología, Asunción, Paraguay
| | - Ileana E Ferreira
- Universidad Nacional de Asunción, Facultad de Odontología, Asunción, Paraguay
| | - Andrea Pedrozo
- Universidad Nacional de Asunción, Facultad de Odontología, Asunción, Paraguay
| | | | - Vicente R Fretes
- Universidad Nacional de Asunción, Facultad de Odontología, Asunción, Paraguay
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Bernardo RCFD, Alves LS, Bruno AMV, Coutinho TMC, Gusman H. The accuracy of electronic apex locators for determining working length: An in vitro study with artificial teeth. AUST ENDOD J 2020; 47:217-221. [PMID: 33368839 DOI: 10.1111/aej.12455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/17/2020] [Accepted: 10/02/2020] [Indexed: 11/28/2022]
Abstract
This study aimed to determine the accuracy of four electronic apex locators (EALs) (I-Root, Propex Pixi, Novapex and Bassi iRoot Apex), using artificial mandibular and maxillary permanent molars. The root length (RL) from 40 artificial teeth was initially determined with Kerr hand files. Then, the electronic RL were obtained for the same root canals with each EAL, and the results were compared with those obtained using hand files. The accuracy of the EALs was determined through analysis of the divergences observed in relation to the lengths obtained with files. All EALs were effective for determining the RL in the artificial teeth, showing results similar to those obtained by hand. The Bassi iRoot Apex had higher accuracy (96.7%) than the Propex Pixi (89.1%) and Novapex (85.8%) (P < 0.05). Based on the results, all EALs tested had a similar performance, and artificial teeth may be used to determine the accuracy of these devices.
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Affiliation(s)
- Raquel C F D Bernardo
- Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Louise S Alves
- Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Adilia M V Bruno
- Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thais M C Coutinho
- Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Heloisa Gusman
- Department of Dental Clinic, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Melo AM, Vivacqua-Gomes N, Bernardes RA, Vivan RR, Duarte MAH, Vasconcelos BCD. Influence of Different Coronal Preflaring Protocols on Electronic Foramen Locators Precision. Braz Dent J 2020; 31:404-408. [PMID: 32901717 DOI: 10.1590/0103-6440202003282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 05/04/2020] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to evaluate the influence of different coronal preflaring protocols (absent, conservative and conventional) on the accuracy of Root ZX II, Raypex 6, and RomiApex A-15 electronic foramen locators (EFLs). Twenty mandibular molars with Vertucci's type IV mesial roots were subjected to endodontic exploration and foraminal patency confirmation. Under 16x magnification, its real lengths (RL) were measured and registered (RL1). The canals were then irrigated with 2.5% sodium hypochlorite and electronically measured (EM1) employing the alginate model; all measurements were performed in triplicate by a blind operator using adjusted endodontic hand-files introduced until the apex foramen. Coronal preflaring procedures were sequentially performed with #25/.06 (conservative) and #25/.12 (conventional) instruments; new RLs extents were performed after each coronal preparation protocol (RL2/RL3), as same as electronic measurements (EM2/EM3). The devices error (mm) was evaluated considering the difference between RLs and EMs at each preparation stage; their precision was stablished adopting ±0.5 mm as tolerance margin. The EFLs error significantly reduced after conventional coronal preflaring protocol (p<0.05), which not occur after the conservative one. The best precisions values were noted after conventional preparation as 90% (Root ZX II), 97.5% (Raypex 6), and 92.5% (RomiApex A-15). No significant differences were found in EFLs comparisons, regardless of the coronal protocol tested (p>0.05). Under the conditions tested it can be concluded that the EFLs evaluated were precise. Moreover, the preflaring protocols influences its accuracy's, where the less conservative one produced the best results.
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Affiliation(s)
- Andrélia Maciel Melo
- School of Dentistry of Ceará, Faculdade São Leopoldo Mandic, Fortaleza, CE, Brazil
| | | | | | - Rodrigo Ricci Vivan
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, USP - Universidade de São Paulo, Bauru, SP, Brazil
| | - Marco Antônio Húngaro Duarte
- Department of Dentistry, Endodontics and Dental Materials, Bauru Dental School, USP - Universidade de São Paulo, Bauru, SP, Brazil
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Kayabasi M, Oznurhan F. Evaluation of the accuracy of electronic apex locators, cone-beam computed tomography, and radiovisiography in primary teeth: An in vitro study. Microsc Res Tech 2020; 83:1330-1335. [PMID: 32589353 DOI: 10.1002/jemt.23524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/18/2020] [Accepted: 05/20/2020] [Indexed: 11/09/2022]
Abstract
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.
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Affiliation(s)
- Mevlut Kayabasi
- Department of Pediatric Dentistry, Faculty of Dentistry, Cumhuriyet University, Sivas, Turkey
| | - Fatih Oznurhan
- Department of Pediatric Dentistry, Faculty of Dentistry, Cumhuriyet University, Sivas, Turkey
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Abdelsalam N, Hashem N. Impact of Apical Patency on Accuracy of Electronic Apex Locators: In Vitro Study. J Endod 2020; 46:509-514. [DOI: 10.1016/j.joen.2020.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 01/07/2020] [Accepted: 01/09/2020] [Indexed: 12/18/2022]
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Marek E, Łagocka R, Kot K, Woźniak K, Lipski M. The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators. BMC Oral Health 2019; 20:3. [PMID: 31892327 PMCID: PMC6938632 DOI: 10.1186/s12903-019-0994-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/19/2019] [Indexed: 11/23/2022] Open
Abstract
Background Accurate determination of working length (WL) is crucial for the success of endodontic therapy. The aim of this study was to determine the influence of 2% chlorhexidine digluconate solution, 2% chlorhexidine digluconate gel and 2% hypochlorite solution on the accuracy of two devices: the Raypex 5 and the ApexDal. Methods Twenty-nine single-rooted human teeth were used in this study. The crowns were cut horizontally and embedded in an alginate mass. In each tooth, six endodontic measurements were made using two electronic apex locators (EALs): a Raypex 5 and an ApexDal. For each EAL, measurements were taken with the following products: 2% chlorhexidine solution (CHX-S group), 2% chlorhexidine gel (CHX-G group) and 2% NaOCl (NaOCl group). After performing an endodontic measurement, the endodontic instruments were stabilized with flow resin composite. Afterwards, the roots were removed from the alginate mass, and the apical one-third of each root was cut lengthways to recover the canal system. Last, the distance between the file tip and the apical foramen was measured under a microscope at 60 x magnification. Results Statistically significant differences were found between CHX-S and NaOCl and CHX-G and NaOCl, but no significant differences were detected between CHX-S and CHX-G during the testing of both devices. No statistically significant differences were observed between the Raypex 5 and ApexDal for all intracanal media tested. Conclusion The EALs Raypex 5 and ApexDal had higher accuracy in the anatomical foramen of the root containing chlorhexidine in the gel or in the solution form than in the canal containing sodium hypochlorite.
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Affiliation(s)
- Ewa Marek
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland.
| | - Ryta Łagocka
- Department of Conservative Dentistry, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Katarzyna Kot
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Krzysztof Woźniak
- Department of Orthodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
| | - Mariusz Lipski
- Department of Preclinical Conservative Dentistry and Preclinical Endodontics, Pomeranian Medical University, Al. Powstańców Wielkopolskich 72, 70-111, Szczecin, Poland
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Serna-Peña G, Gomes-Azevedo S, Flores-Treviño J, Madla-Cruz E, Rodríguez-Delgado I, Martínez-González G. In Vivo Evaluation of 3 Electronic Apex Locators: Root ZX Mini, Apex ID, and Propex Pixi. J Endod 2019; 46:158-161. [PMID: 31839411 DOI: 10.1016/j.joen.2019.10.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 10/27/2019] [Accepted: 10/30/2019] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The aim of this in vivo study was to compare the accuracy of 3 electronic apex locators (EALs) (Root ZX mini [J Morita Corp, Tokyo, Japan], Apex ID [SybronEndo, Glendora, CA], and Propex Pixi [Dentsply Maillefer, Ballaigues, Switzerland]) to determine the working length. METHODS Thirty single-rooted human teeth that were scheduled for extraction were selected for the study. Electronic measurements were performed with the 3 EALs. After the teeth had been extracted, a #10 K-file was used to determine the actual working length, which was established at 0.5 mm short of the major foramen. The data were statistically analyzed with analysis of variance (α = 0.05). RESULTS No significant differences were found among the experimental groups (P > .05). The mean distance from the actual working length to the file tip was 0.163 ± 0.032 mm when Root ZX mini was used, 0.343 ± 0.032 mm for Propex Pixi , and 0.012 ± 0.008 mm for Apex ID. CONCLUSIONS Under the in vivo conditions of this study, no statistically significant differences were observed among the 3 EALs.
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Affiliation(s)
- Gabriela Serna-Peña
- Department of Endodontics, Universidad Autónoma de Nuevo Léon, Monterrey, Nuevo Léon, Mexico
| | - Susana Gomes-Azevedo
- Department of Endodontics, Universidad Autónoma de Nuevo Léon, Monterrey, Nuevo Léon, Mexico.
| | - Jorge Flores-Treviño
- Department of Endodontics, Universidad Autónoma de Nuevo Léon, Monterrey, Nuevo Léon, Mexico
| | - Elizabeth Madla-Cruz
- Department of Endodontics, Universidad Autónoma de Nuevo Léon, Monterrey, Nuevo Léon, Mexico
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The Precision of Propex Pixi with Different Instruments and Coronal Preflaring Procedures. Eur Endod J 2019; 4:75-79. [PMID: 32161891 PMCID: PMC7006547 DOI: 10.14744/eej.2019.52724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2019] [Indexed: 11/20/2022] Open
Abstract
Objective This study aimed to evaluate the influence of the instrument regarding the apical fit and type of the alloy and coronal preflaring procedures in the accuracy of Propex Pixi. Methods A total of 40 extracted human single-rooted permanent teeth with apical diameters of 200 µm were selected. A #10 K-file was inserted in the root canal until its end could be observed by a dental microscope to obtain the actual working length (WL). Electronic measurements were performed using Propex Pixi to the root apex ("0.0"). Different file alloys (stainless steel [SS] and nickel titanium [NiTi]) and sizes (#10, #15, and #20) were used before and after coronal flaring. Statistical analysis was performed by a factorial analysis of variance (P≤0.05). Results Results showed that the measurements of electronic length (EL) were closer to the actual working length (WL) after coronal flaring (P<0.05). A significant intraclass correlation was observed between EL and WL. In addition, results showed no significant differences between files with different sizes or alloys. Conclusion Under the conditions of this study, Propex Pixi demonstrated adequate precision. Its accuracy was enhanced by coronal preflaring procedures regardless of the instrument type used (SS or NiTi) and the apical fit.
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Vanitha S, Sherwood IA. Comparison of three different apex locators in determining the working length of mandibular first molar teeth with irreversible pulpitis compared with an intraoral periapical radiograph: A block randomized, controlled, clinical trial. ACTA ACUST UNITED AC 2019; 10:e12408. [PMID: 30838781 DOI: 10.1111/jicd.12408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 12/13/2018] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to assess the clinical accuracy APEX and 0.5 marks of three different apex locators - iPex II, Root ZX, and Apex ID - before and after canal preparation in the mandibular first molar. METHODS Sixty patients between the ages of 13-60 years participated in the study. After access gaining and canal preparation stages files were inserted with the apex locator clip attached until the electronic apex locators (EALs) shows readings of APEX and 0.5 marks and same is confirmed with periapical radiographs. Eighteen apex locator readings were recorded from each tooth, and 1080 readings were obtained from the 60 patients. RESULTS Differences among readings from apex locators and radiographic readings were assessed using paired t test. Only in two patients (1 male and 1 female) were the APEX mark readings different from the radiograph estimation. When the 0.5 mark readings of three different EALs were compared with each other, we could observe that the readings from Root ZX differed significantly (P < 0.05). CONCLUSIONS In the present study, we observed the negligible differences in readings between the EAL at the APEX mark readings, coinciding with the radiographic observation. Clinically, we recommend the apical foramen be located with the apex locators' APEX mark readings prior to identifying the apical constriction position.
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Affiliation(s)
- Sadashivam Vanitha
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - I Anand Sherwood
- Department of Conservative Dentistry and Endodontics, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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El Hachem R, Wassef E, Mokbel N, Abboud R, Zogheib C, El Osta N, Naaman A. Influence of the Maxillary Sinus on the Accuracy of the Root ZX Apex Locator: An Ex Vivo Study. Dent J (Basel) 2019; 7:dj7010003. [PMID: 30609762 PMCID: PMC6473460 DOI: 10.3390/dj7010003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 11/15/2018] [Accepted: 12/11/2018] [Indexed: 11/30/2022] Open
Abstract
This study evaluated the accuracy of the Root ZX (J. Morita, Tokyo, Japan) electronic apex locator in determining the working length when palatal maxillary molar roots are in a relationship with the sinus. Seventeen human maxillary molars with vital pulp were scheduled for an extraction and implant placement as part of a periodontal treatment plan. The access cavity was prepared, and a #10 K file (Dentsply Maillefer, Ballaigues, Switzerland) was inserted into the palatal root using the Root ZX apex locator in order to determine the electronic working length (EWL); then, the teeth were extracted. To determine the real working length (RWL), a #10 K file was introduced into the root canal until its tip touched a glass plate. EWL and RWL were compared. Images reconstructed with CBCT (cone beam computerized tomography) revealed that eight palatal roots were related to the maxillary sinus, whereas nine were not. The results showed a significant difference between the EWL and the RWL of the palatal roots related to the sinus (p < 0.001). No significant difference was observed in measurements of roots not in contact with the sinus (p > 0.05). Within the study limitations, the reliability of Root ZX was influenced by the relationship of the roots with the maxillary sinus.
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Affiliation(s)
- Roula El Hachem
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Elie Wassef
- Department of Periodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Nadim Mokbel
- Department of Periodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Richard Abboud
- Department of Maxillo-Facial Radiology, Saint Joseph University, B.P. 11-514 Riad el-Solh, Beirut 1107 2050, Lebanon.
| | - Carla Zogheib
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
| | - Nada El Osta
- Department of Prosthodontics, Saint Joseph University, B.P. 11-514 Riad el-Solh, Beirut 1107 2050, Lebanon.
| | - Alfred Naaman
- Department of Endodontics, Faculty of Dentistry, Saint Joseph University, P.O. Box 11-5076 Riad el-Solh, Beirut 1107 2180, Lebanon.
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Piasecki L, José dos Reis P, Jussiani EI, Andrello AC. A Micro–computed Tomographic Evaluation of the Accuracy of 3 Electronic Apex Locators in Curved Canals of Mandibular Molars. J Endod 2018; 44:1872-1877. [DOI: 10.1016/j.joen.2018.09.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 08/28/2018] [Accepted: 09/03/2018] [Indexed: 11/28/2022]
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Lvovsky A, Bachrach S, Kim HC, Pawar A, Levinzon O, Ben Itzhak J, Solomonov M. Relationship between Root Apices and the Mandibular Canal: A Cone-beam Computed Tomographic Comparison of 3 Populations. J Endod 2018; 44:555-558. [DOI: 10.1016/j.joen.2017.12.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/16/2017] [Accepted: 12/26/2017] [Indexed: 10/18/2022]
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