Clinical accuracy of two electronic apex locators in teeth with large periapical lesions

The study aimed to compare and evaluate the accuracy of iPex, Root ZX mini, and Epex Pro Electronic apex locators (EALs) in diagnosing root perforations in both dry and in different wet conditions: 5% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and 17% Ethylenediaminetetraacetic acid (EDTA). Methods: Thirty extracted, human single rooted mandibular premolars were artificially perforated with a diameter of 1.5 mm in middle third of root. Actual canal lengths (ALs) in millimetre (mm) were evaluated for all teeth up to perforation location, and alginate mould were used to embed the teeth. After this, the electronic measurements were calculated by all EALs up to perforation site using a 20 K-file in both dry and wet canal conditions. Up to the perforation sites, the ALs were subtracted from the electronic length. Statistical analyses were done using One-way ANOVA with post hoc tukey's test for pairwise comparison and the level of significance was set at 0.05. Results: All three EAL's detected canal perforations which were clinically acceptable. There was significant difference for dry and wet conditions. Most accurate measurement were seen in dry canals for all three EALs. Root ZX mini in dry condition showed most accurate reading and there was a significant difference when compared with other groups. No significance difference was observed in iPex and Epex Pro Apex locator, and between NaOCl and CHX, CHX and EDTA. Conclusion: Perforations were determined within a clinical acceptable range of 0.03-0.05 mm by all three EALs. Root ZX mini in dry canals gave most accurate measurement. The presence of irrigating solution influenced the accuracy of all the apex locators.

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“…To measure accuracy of the EALs, +/-0.5 mm difference has been considered accurate in various studies (11,19,24,25,26).…”

Section: Resultsmentioning

confidence: 99%

Comparative evaluation of accuracy of ipex, root zx mini, and epex pro apex locators in teeth with artificially created root perforations in presence of various intracanal irrigants

et al. 2020

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“…Only very limited designs of clinical studies are available for assessing the accuracy of apex locators. Commonly used in vivo study designs evaluate the accuracy of EAL prior and after the extraction of periodontally‐weak teeth or teeth intended for orthodontic extraction, subjecting the patient to cone‐beam computed tomography (CBCT) or testing the EAL during apical surgery . Each study design has its own limitations in replicating the clinical scenario where the EAL are required to operate.…”

Section: Discussionmentioning

confidence: 99%

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

Vanitha¹,

Sherwood²

2019

J of Invest & Clin Dent

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Accurate determination of the root canal apical termini is essential for a successful root canal treatment. 1 Failure to locate the working length precisely could compromise the clinical outcome of the root canal treatment. 1 Variations in root morphology and radiograph distortion might cause the radiographic apex to differ from the anatomic apex. 2,3 The exact termination point for root canal preparation has been a major subject of debate for decades; 4 in teeth with vital pulps and normal periapical tissues, a higher clinical success rate was achieved when canal preparation ended 1 mm from the radiographic apex, short of the apical foramen at the dentin-cemental junction. 4The drawbacks of employing a radiograph for the determination of working length include the image being only a 2-D representation of the root canal system, a paralleling technique is not always feasible with digital radiographic techniques, and there are concerns with radiation exposure. 5-7 These drawbacks have allowed the apex locators to be widely accepted and are the preferred method for working length determination. A systematic review on the clinical efficacy and accuracy of electronic apex locators reported that 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 readingswere 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. K E Y W O R D Sapex locator, apical constriction, apical foramen, mandibular first molar, working length

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“…This posed some clinical concerns. The working length was initially confirmed with an electronic apex locator because Ç alişkan et al (39) have shown that electronic apex locators can be used with a high level of accuracy in canals with persistent intracanal exudate where teeth have had large periapical lesions. The canals were redressed primarily because the cone-beam imaging revealed the lesion had extended to involve the apices of the canine and first premolar teeth (Fig.…”

Section: Discussionmentioning

confidence: 99%

Healing of a Cyst-like Lesion Involving an Implant with Nonsurgical Management

Kahler

2015

Journal of Endodontics

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Clinical accuracy of two electronic apex locators in teeth with large periapical lesions

Cited by 9 publications

References 37 publications

Comparative evaluation of accuracy of ipex, root zx mini, and epex pro apex locators in teeth with artificially created root perforations in presence of various intracanal irrigants

Comparative evaluation of accuracy of ipex, root zx mini, and epex pro apex locators in teeth with artificially created root perforations in presence of various intracanal irrigants

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

Healing of a Cyst-like Lesion Involving an Implant with Nonsurgical Management

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