Accuracy of the iPex multi-frequency electronic apex locator in primary molars: an ex vivo study

Deciduous Molars Complexity Anatomy Reveled by Computed Microtomography

OBJECTIVE

 The aim of this study was to analyze the internal morphology of deciduous molars through the use of computed microtomography in a sample from Rio de Janeiro.

MATERIAL AND METHODS

 Thirty maxillary and 30 mandibular deciduous molars (n = 60), divided in first and second primary molars, were scanned by computed microtomography. The teeth were evaluated for root number, root canals, Vertucci classification, root curvature, presence of lateral canals, furcation dentin thickness, structure model index (SMI), volume, and canal surface area.

RESULTS

 The results showed 100% of maxillary molars had three roots and Vertucci type I canal was more prevalent in this group. In the mandibular ones, type IV was more frequent in the mesial root and class I in the distal root and the cavo-interradicular canal occurred in 2 specimens. Dentin thickness in the furcation region measured 1.53 and 1.59 mm in the maxillary and mandibular, respectively. Volume and area parameters varied according to the evaluated canals and SMI demonstrated that all canals had a cylindrical shape.

CONCLUSION

 More detailed information about the internal anatomy of the primary molars has been described, which may help strategies in the preparation of these root canals.

Is there any difference in length measurement methods for pulpectomies in primary teeth?-A double-blind, controlled clinical trial

BACKGROUND

Working length is an important step in primary teeth pulpectomy.

AIM

To evaluate whether there is a significant difference in the accuracy of electronic apex locators compared to the conventional radiography in working length measurements.

DESIGN

Sixty-four children (192 canals) between 5 and 9 years of age with indication for pulpectomy of a primary molar were included after eligibility criteria. A radiographic measurement was obtained from pre-operative radiography from the cusp tip to the apex or resorption of the root. The electronic measurement was obtained from a complete measurement of the canal with an electronic device up to the apex. Data were analysed with Bland-Altman plots and Wilcoxon test. Statistical significance was set at P ≤ .05.

RESULTS

Statistically, there is not any significant difference between radiographic and electronic measurements for the palatal canal or distal canal, as well as mesiobuccal canals (P > .05). Statistically, there, however, is a significant difference between the measurements for the distobuccal canal and mesiolingual canal measurements (P < .05). High internal consistency for both radiographic and electronic methods was achieved (α ≅ 1).

CONCLUSIONS

Electronic and radiographic methods are similar in determining the length measurement of the root canals in primary teeth pulpectomies, except in distobuccal or mesiolingual canals.

A smart rotary technique versus conventional pulpectomy for primary teeth: A randomized controlled clinical study

Background

Techniques with adequate accuracy of working length determination along with shorter duration of treatment in pulpectomy procedure seems to be essential in pediatric dentistry. The aim of the present study was to evaluate the accuracy of root canal length measurement with Root ZX II apex locator and rotary system in pulpectomy of primary teeth.

Material and Methods

In this randomized control clinical trial complete pulpectomy was performed on 80 mandibular primary molars in 80, 4-6-year-old children. The study population was randomly divided into case and control groups. In control group conventional pulpectomy was performed and in the case group working length was determined by electronic apex locator Root ZXII and instrumented with Mtwo rotary files. Statistical evaluation was performed using Mann-Whitney and Chi-Square tests (P<0.05).

Results

There were no significant differences between electronic apex locator Root ZXII and conventional method in accuracy of root canal length determination. However significantly less time was needed for instrumenting with rotary files (P=0.000).

Conclusions

Considering the comparable results in accuracy of root canal length determination and the considerably shorter instrumentation time in Root ZXII apex locator and rotary system, it may be suggested for pulpectomy in primary molar teeth.

Key words:Rotary technique, conventional technique, pulpectomy, primary teeth.

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.

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.

Clinical evaluation of apex locator and radiography in primary teeth

AIM

The aim of this in vivo study was to evaluate the accuracy and reliability of electronic apex locater and radiographic determination of root canal length in primary teeth.

METHODOLOGY

A total of 32 human primary molar teeth (96 roots) were selected. After endodontic access preparation, root canals were irrigated with physiological saline solution. The access cavities were dried with cotton pellets and, the roots were dried with paper points before performing the electronic measurement. The root canal length measurements were first taken with an apex locater (EndoMaster), and then, a size ♯ 15 K-file was inserted into the root canal, and radiography was taken to determine the working length measurements. The measurement data were recorded and compared by one-way anova and Kruskal-Wallis tests. P < 0.05 was accepted for the significance.

RESULTS

The mean values for radiography were 13.23 ± 1.92 mm and for EndoMaster were 13.08 ± 1.77 mm. The accuracy of EndoMaster was 80.2% in correct measurements ±1 mm (P < 0.001).

CONCLUSION

The electronic apex locators could be useful in determining working length and thereby decreasing the need for radiographs and exposure to ionizing radiation in pediatric dental patients.

Accuracy of five electronic foramen locators with different operating systems: an ex vivo study

OBJECTIVE

The aim of this study was to evaluate, ex vivo, the precision of five electronic root canal length measurement devices (ERCLMDs) with different operating systems: the Root ZX, Mini Apex Locator, Propex II, iPex, and RomiApex A-15, and the possible influence of the positioning of the instrument tips short of the apical foramen.

MATERIAL AND METHODS

Forty-two mandibular bicuspids had their real canal lengths (RL) previously determined. Electronic measurements were performed 1.0 mm short of the apical foramen (-1.0), followed by measurements at the apical foramen (0.0). The data resulting from the comparison of the ERCLMD measurements and the RL were evaluated by the Wilcoxon and Friedman tests at a significance level of 5%.

RESULTS

Considering the measurements performed at 0.0 and -1.0, the precision rates for the ERCLMDs were: 73.5% and 47.1% (Root ZX), 73.5% and 55.9% (Mini Apex Locator), 67.6% and 41.1% (Propex II), 61.7% and 44.1% (iPex), and 79.4% and 44.1% (RomiApex A-15), respectively, considering ±0.5 mm of tolerance. Regarding the mean discrepancies, no differences were observed at 0.0; however, in the measurements at -1.0, the iPex, a multi-frequency ERCLMD, had significantly more discrepant readings short of the apical foramen than the other devices, except for the Propex II, which had intermediate results. When the ERCLMDs measurements at -1.0 were compared with those at 0.0, the Propex II, iPex and RomiApex A-15 presented significantly higher discrepancies in their readings.

CONCLUSIONS

Under the conditions of the present study, all the ERCLMDs provided acceptable measurements at the 0.0 position. However, at the -1.0 position, the ERCLMDs had a lower precision, with statistically significant differences for the Propex II, iPex, and RomiApex A-15.