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

Davalbhakta, Rucha; Gokhale, Niraj; Hugar, Shivayogi M; Badakar, Chandrashekhar; Gowtham, A; Soneta, Sanjana P

doi:10.1016/j.jobcr.2021.02.007

Cited by 5 publications

(26 citation statements)

References 15 publications

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“…In the sensitivity analysis, when considering only studies that were evaluated as 'low risk of bias' (Bhat et al, 2017;de Alencar et al, 2019;Oznurhan et al, 2015 difference between the electronic and radiographic measurements was −0.63 (95% CI [−1.15 to −0.10]; p = .02) (Figure S2). Nine studies were included for the radiovisiographic method (Abdullah et al, 2016;Awasthi et al, 2017;Balaji & Pravallika, 2019;Davalbhakta et al, 2021;Koruyucu et al, 2018;Kumar et al, 2016;Neena et al, 2011;Saritha et al, 2012;Wankhade et al, 2013), two for SEM (Koruyucu et al, 2018;Patino-Marin et al, 2011), and four for the visual direct method (Alafandy, 2018;Kumar et al, 2016;Senthil et al, 2016;Wankhade et al, 2013). The analysis showed that the electronic measurement did not differ statistically from the radiovisiographic method (−0.09; 95% CI [−0.22 to 0.04]; p = .20), SEM (−0.16; 95% CI [−0.83 to 0.50]; p = .63), and visual direct method (−0.05; 95% CI [−0.36 to 0.26]; p = .75).…”

Section: Results Of Individual Studiesmentioning

confidence: 99%

“…Inter-and intra-examiner agreement was assessed only in 11 studies, in which values were considered excellent for all analyses used: Kappa (0.87 to 0.98) (Davalbhakta et al, 2021;Koruyucu et al, 2018;Kumar et al, 2016;Odabaş et al, 2011), ICC (0.80 to 0.99) (Alafandy, 2018;Hafiz, 2018a;Patino-Marin et al, 2011;Wankhade et al, 2013), Cronbach's alpha (0.95 to 0.99) (Alafandy, 2018;de Alencar et al, 2019), and Altmann & Bland (0.98) (Kielbassa et al, 2003).…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…During the risk of bias assessment, inappropriate exclusions, not reporting the exclusion F I G U R E 2 Meta-analysis comparing the mean lengths between the measurements obtained by the electronic method and the comparative methods: radiography, radiovisiography, SEM, and visual direct. criteria and failure in reporting sample randomization in the randomized trials, rated the domain patient selection as 'high risk of bias' (Alafandy, 2018;Caliskan et al, 2021;Dandempally et al, 2013;Davalbhakta et al, 2021;Hafiz, 2018a;Kumar et al, 2016;Neena et al, 2011;Rathore et al, 2020;Soruri et al, 2013). For the index test and reference standard domains, the non-blinding of the examiners or the knowledge of the comparison measure before the electronic measurement attributed the concept of 'high risk of bias' (Abdullah et al, 2016;Dandempally et al, 2013;Neena et al, 2011;Nellamakkada et al, 2020;Sankar & Jeevanandan, 2021;Saritha et al, 2012).…”

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

“…A previous systematic review (Ahmad & Pani, 2015) was carried out; however, some limitations in this study need to be overcome to increase the certainty of the evidence, as most of the included studies were in vitro investigations. The most reliable evidence is obtained from well-conducted clinical studies and, since 2013 (the search date of the previous systematic review), several clinical studies have been performed to assess the accuracy of different EALs used for working length determination in primary teeth (Abdullah et al, 2016;Alafandy, 2018;Awasthi et al, 2017;Balaji & Pravallika, 2019;Bhat et al, 2017;Caliskan et al, 2021;Dandempally et al, 2013;Davalbhakta et al, 2021;de Alencar et al, 2019;Hafiz, 2018a;Koruyucu et al, 2018;Kumar et al, 2016;Nellamakkada et al, 2020;Nogorani et al, 2014;Oznurhan et al, 2015;Rathore et al, 2020;Sankar & Jeevanandan, 2021;Senthil et al, 2016;Sivadas et al, 2013;Soruri et al, 2013;Wankhade et al, 2013). However, the results of these studies have not been are based on clinical studies with low methodological quality and high heterogeneity, which require careful interpretation for clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Are electronic apex locators accurate in determining working length in primary teeth pulpectomies? A systematic review and meta‐analysis of clinical studies

et al. 2022

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Background The lack of a well‐defined apical constriction in primary teeth raises concerns regarding the accuracy of electronic apex locators (EALs) for measuring working length. Objectives To evaluate the accuracy of EALs in determining working length in primary teeth pulpectomies. Methods Two reviewers searched ten databases up to September 2021. Clinical studies evaluating the accuracy of the electronic measurement of working length in primary teeth pulpectomies were included. Studies without a comparison group, with samples smaller than ten root canals, and that did not use a multiple frequency EAL were excluded. A meta‐analysis was conducted to assess the paired differences in mean lengths between measurements obtained by electronic and comparative methods. In addition, a meta‐analysis of proportion was applied according to the level of difference between the measures. The risk of bias and applicability of the studies were assessed using the QUADAS‐2 tool. The certainty of evidence was assessed with the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results Twenty‐nine studies were included in the qualitative analysis and twenty‐three in the quantitative analysis. The methods of comparison for the electronic measurement were the radiographic method, radiovisiographic, scanning electron microscopy, and direct visualization. The meta‐analysis showed that the electronic measurement tends to be shorter than radiographic measurement, while the other methods showed no difference. The proportion analysis showed a higher pooled proportion of difference values between electronic and comparative measurements within −0.5 to +0.5 mm (69.31%). The certainty of the evidence suggested very low confidence in estimating the outcome. Discussion The results of this review denote a good performance of the EALs in determining working length in primary teeth pulpectomies. However, these results are based on clinical studies with low methodological quality and high heterogeneity, which require careful interpretation for clinical practice. Conclusions Although the results suggest acceptable accuracy of EALs in determining working length in primary teeth pulpectomies, the low quality of the included studies and the very low certainty of the evidence require clinicians to interpret these results with caution. More robust evidence is required to support that these devices are accurate for primary teeth. Registration CRD42021277414 (PROSPERO).

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Section: Results Of Individual Studiesmentioning

confidence: 99%

Section: Study Selection and Characteristicsmentioning

confidence: 99%

Section: Risk Of Bias Assessmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Are electronic apex locators accurate in determining working length in primary teeth pulpectomies? A systematic review and meta‐analysis of clinical studies

et al. 2022

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“…Root ZX is used as the gold standard in many studies (32). The accuracy of this EAL ranges from 56.2% to 95% in in vitro studies (31,33).…”

Section: Discussionmentioning

confidence: 99%

Comparison of the accuracy of three different electronic apex locators used in root canals enlarged in different apical diameters

Öz

Adıgüzel

2021

Int Dent Res

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Aim: This study aimed to evaluate the accuracy of three apex locators in enlarged teeth with different apical diameters using files that are compatible and incompatible with the apical diameters. Methodology: Sixty lower premolars were used in this study. The actual canal length was determined with a stereo microscope, and the teeth were divided into three different groups (G25, G40 and G50). The teeth in G25, G40 and G50 were enlarged in actual canal length with apical diameters of 0.25, 0.40 and 0.50 mm using hand files and Reciproc R25, R40, and R50, respectively. In the electronic measurements, a #15 hand file was used in each group, and #25, #40 and #50 hand files that were compatible with the apical diameters of the teeth in the groups were used. An alginate model was created with enlarged teeth. The electronic working length was determined for each tooth using Root ZX Mini, Raypex 6, and Propex Pixi electronic apex locators (EALs). Results: Electronic measurement results that were shorter by 0.50 mm or longer by 0.05 mm than the actual length were considered unsuccessful; otherwise, they were deemed successful. Analysis of variance was used to evaluate the accuracy of the EALs with different files in the same apical diameter. For the different apical diameters, the chi-square exact test was used to evaluate the accuracy effect of using files that were incompatible with each apical diameter. The level of significance was p > 0.05. In all the groups, the measured lengths were closer to the actual canal length with the use of #25, #40 and #50 hand files that were compatible with the apical diameters. However, there was no significant difference between the measurements with the #15 hand file (p > 0.05). According to the electronic measurement results made with the #15 hand file in teeth with 0.25, 0.40 and 0.50 apical diameters, the use of a file that was incompatible with the apical diameter did not have a significant effect on accuracy (p > 0.05). Conclusion: The use of a file that is compatible with the apical diameter of the tooth in the determination of the working length with measurement of EALs close to the actual canal length. The accuracy of EALs is not affected by the file size in electronic measurements with file sizes smaller than the apical diameter in teeth with apical diameters up to 0.50 mm. How to cite this article: Öz H, Adıgüzel Ö, Kaya S. Comparison of the accuracy of three different electronic apex locators used in root canals enlarged in different apical diameters. Int Dent Res 2021;11(Suppl.1):12-8. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.3 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

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Advances in Working Length Determination

Nekoofar¹

2022

Endodontic Advances and Evidence‐Based Clinical Guidelines

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

Cited by 5 publications

References 15 publications

Are electronic apex locators accurate in determining working length in primary teeth pulpectomies? A systematic review and meta‐analysis of clinical studies

Are electronic apex locators accurate in determining working length in primary teeth pulpectomies? A systematic review and meta‐analysis of clinical studies

Comparison of the accuracy of three different electronic apex locators used in root canals enlarged in different apical diameters

Advances in Working Length Determination

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