The Accuracy of Different Apex Locator Systems in Detecting Root Perforations in the Presence of Different Irrigation Solutions


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DOI:

https://doi.org/10.58600/eurjther1936

Keywords:

Apex locator, Apex ID, Electroconductivity, Raypex 6, Root ZX

Abstract

Objective: One of the most studied topics in electronic apex locators (EALs) is the effect of root canal condition on the accuracy of EALs. In this study, the accuracy of Root ZX Mini, Raypex 6, and Apex ID in detecting root perforation was evaluated in a dry environment and in the presence of saline, ethylenediamine tetraacetic acid (EDTA), and sodium hypochlorite (NaOCl) solutions.

Methods: The mesiobuccal roots of 64 human maxillary first molars were selected for the study. These root canals were perforated from buccal root surface using a #1 Freze Beutherlock Peeso to form a 0.4 mm cavity. After perforation, the area where #40 K type file appeared was recorded as the actual length (AL) and the length measured by EAL devices both in dry canals and in the presence of solutions was recorded as the electronic measurement (EL). All electronic measurements were statistically compared with the actual length.

Results: All EALs achieved AL-consistent results on EL measures. Consistency was determined using Root ZX Mini measurements in dry canals and canals irrigated with saline. The consistency of EL and AL conducted with Raypex 6 and Apex ID in canals irrigated with NaOCl, saline, and EDTA was found. There was a statistically significant difference in ELs with irrigation solutions among all EALs (p<0.05). In the dry environment, there was no statistically significant difference between the EALs (p>0.05). A consistency was discovered between ELs generated with the Root ZX Mini and ALs in both dry and saline-irrigated canals. Consistency was observed between ELs measured with Raypex 6 and Apex ID and ALs in canals irrigated with NaOCl, saline, and EDTA.

Conclusion: The accuracy rates of the EALs used in this research were 97%–100% in the 1 mm range and 83%–92% in the 0.5 mm range. Despite the fact that ALs and ELs differed statistically significantly at the 0.05 level, these variations weren't thought to be clinically relevant. In the presence of conditions with different electro conductors, EALs from different generations may be used safely, and in a range of canal situations, these devices can yield measurements that are most similar to the AL.

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References

Siew K, Lee AH, Cheung GS (2015) Treatment outcome of repaired root perforation: a systematic review and meta-analysis. J Endod. 41(11):1795-804. https://doi.org/10.1016/j.joen.2015.07.007

Gorni FG, Andreano A, Ambrogi F, Brambilla E, Gagliani M (2016) Patient and clinical characteristics associated with primary healing of iatrogenic perforations after root canal treatment: results of a long-term Italian study. J Endod. 42(2):211-5. https://doi.org/10.1016/j.joen.2015.11.006

Kaufman A, Fuss Z, Keila S, Waxenberg S (1997) Reliability of different electronic apex locators to detect root perforations in vitro. Int Endod J. 30(6):403-7. https://doi.org/10.1046/j.1365-2591.1997.00107.x

Tinaz AC, Alacam T, Uzun O, Maden M, Kayaoglu G (2005) The effect of disruption of apical constriction on periapical extrusion. J Endod. 31(7):533-5. https://doi.org/10.1097/01.don.0000152294.35507.35

Altunbaş D, Kuştarcı A, Toyoğlu M (2017) The influence of various irrigants on the accuracy of 2 electronic apex locators in locating simulated root perforations. J Endod. 43(3):439-42. https://doi.org/10.1016/j.joen.2016.10.031

D'Assunção FLC, Sousa JCN, Felinto KCA, de Medeiros TC, Leite DT, de Lucena RB, De Oliveira Lima J (2014) Accuracy and repeatability of 3 apex locators in locating root canal perforations: an ex vivo study. J Endod. 40(8):1241-4. https://doi.org/10.1016/j.joen.2014.02.004

Üstün Y, Aslan T, Şekerci AE, Sağsen B (2016) Evaluation of the reliability of cone-beam computed tomography scanning and electronic apex locator measurements in working length determination of teeth with large periapical lesions. J Endod. 42(9):1334-7. https://doi.org/10.1016/j.joen.2016.06.010

Tsesis I, Fuss Z (2006) Diagnosis and treatment of accidental root perforations. Endod Topics. 13(1):95-107. https://doi.org/10.1111/j.1601-1546.2006.00213.x

D'addazio P, Campos C, Özcan M, Teixeira H, Passoni R, Carvalho A (2011) A comparative study between cone‐beam computed tomography and periapical radiographs in the diagnosis of simulated endodontic complications. Int Endod J. 44(3):218-24. https://doi.org/10.1111/j.1365-2591.2010.01802.x

Sunada I (1962) New method for measuring the length of the root canal. J Dent Res. 41(2):375-87. https://doi.org/10.1177/00220345620410020801

Shin H-S, Yang W-K, Kim M-R, Ko H-J, Cho K-M, Park S-H, Kim JW. (2012) Accuracy of Root ZX in teeth with simulated root perforation in the presence of gel or liquid type endodontic irrigant. Restor Dent Endod. 37(3):149-54. https://doi.org/10.5395/rde.2012.37.3.149

Muthu M, Sivakumar N (2006) Accuracy of electronic apex locator in length determination in the presence of different irrigants: An: in vitro: study. J Indian Soc Pedod Prev Dent. 24(4):182-5. https://doi.org/10.4103/0970-4388.28074

Kumar LV, Sreelakshmi N, Reddy ER, Manjula M, Rani ST, Rajesh A (2016) Clinical evaluation of conventional radiography, radiovisiography, and an electronic apex locator in determining the working length in primary teeth. Pediatr Dent. 38(1):37-41.

Chaudhary S, Gharti A, Adhikari B (2018) An in vivo comparison of accuracy of two electronic apex locators in determining working length using stainless steel and nickel titanium files. Clin Cosmet Investig Dent. 10:75-82. https://doi.org/10.2147/CCIDE.S158882

Marek E, Łagocka R, Kot K, Woźniak K, Lipski M (2020) The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators. BMC Oral Health. 20:1-8. https://doi.org/10.1186/s12903-019-0994-z

Bilaiya S, Patni PM, Jain P, Pandey SH, Raghuwanshi S, Bagulkar B (2020). 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. Eur Endod J. 5(1):6-9. https://doi.org/10.14744/eej.2019.07279

Tsesis I, Rosenberg E, Faivishevsky V, Kfir A, Katz M, Rosen E (2010) Prevalence and associated periodontal status of teeth with root perforation: a retrospective study of 2,002 patients' medical records. J Endod. 36(5):797-800. https://doi.org/10.1016/j.joen.2010.02.012

Satir S, Buyukcavus MH, Orhan K. (2021) A novel approach to radiographic detection of bucco-palatal/lingual dilacerations: A preliminary study with ImageJ. Proc Inst Mech Eng. 235(11):1310-1314. https://doi.org/10.1177/09544119211030717

Khojastepour L, Moazami F, Babaei M, Forghani M (2015) Assessment of root perforation within simulated internal resorption cavities using cone-beam computed tomography. J Endod. 41(9):1520-3. https://doi.org/10.1016/j.joen.2015.04.015

Fouad AF, Rivera EM, Krell KV (1993) Accuracy of the endex with variations in canal irrigants and formane size. J Endod. 19(2):63-7. https://doi.org/10.1016/S0099-2399(06)81196-9

Duran-Sindreu F, Stöber E, Mercadé M, Vera J, Garcia M, Bueno R, Roig M (2012) Comparison of in vivo and in vitro readings when testing the accuracy of the Root ZX apex locator. J Endod. 38(2):236-9. https://doi.org/10.1016/j.joen.2011.10.008

Weiger R, John C, Geigle H, Löst C (1999) An in vitro comparison of two modern apex locators. J Endod. 25(11):765-8. https://doi.org/10.1016/S0099-2399(99)80128-9

Meares WA, Steiman HR (2002) The influence of sodium hypochlorite irrigation on the accuracy of the Root ZX electronic apex locator. J Endod. 28(8):595-8. https://doi.org/10.1097/00004770-200208000-00008

Baldi JV, Victorino FR, Bernardes RA, de Moraes IG, Bramante CM, Garcia RB, Bernardineli N (2007) Influence of embedding media on the assessment of electronic apex locators. J Endod. 33(4):476-9. https://doi.org/10.1016/j.joen.2006.12.024

Chen E, Kaing S, Mohan H, Ting S-Y, Wu J, Parashos P (2011) An ex vivo comparison of electronic apex locator teaching models. J Endod. 37(8):1147-51. https://doi.org/10.1016/j.joen.2011.03.032

Zmener O, Grimberg F, Banegas G, Chiacchio L (1999) Detection and measurement of endodontic root perforations using a newly designed apex‐locating handpiece. Dent Traumatol. 15(4):182-5. https://doi.org/10.1111/j.1600-9657.1999.tb00798.x

Fuss Z, Assooline LS, Kaufman AY (1996) Determination of location of root perforations by electronic apex locators. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 82(3):324-9. https://doi.org/10.1016/S1079-2104(96)80361-1

Koç S, Kuştarcı A, Er K. (2023) Accuracy of different electronic apex locators in determination of minimum root perforation diameter. Aust Endod J. 49:179-86. https://doi.org/10.1111/aej.12711

Kaufman A, Keila S, Yoshpe M (2002) Accuracy of a new apex locator: an in vitro study. Int Endod J. 35(2):186-92. https://doi.org/10.1046/j.1365-2591.2002.00468.x

Doğan T, Aydin ZU, Altunbaş D (2021) The effect of various canal contents on the accuracy of two electronic apex locators in detecting different size of root perforations. Clin Exp Health Sci. 11(2):258-62. https://doi.org/10.33808/clinexphealthsci.739588

Srivastava S, Gaikwad R, Dalal A. (2020) Comparative evaluation of the effect of various irrigants and dry canal on electronic apex locators in locating simulated root perforations: an in vitro study. Braz Dent Sci. 23(1):6 p.- p. https://doi.org/10.14295/bds.2020.v23i1.1856

Aydın ZU, Altunbaş D, Meşeci B (2020) The effect of different irrigation solutions on the accuracy of two electronic apex locators in locating artificial root perforations. Meandros Med Dent J. 21:134-139. https://doi.org/10.4274/meandros.galenos.2020.41196

Shabahang S, Goon WW, Gluskin AH (1996) An in vivo evaluation of Root ZX electronic apex locator. J Endod. 22(11):616-8. https://doi.org/10.1016/S0099-2399(96)80033-1

Venturi M, Breschi L (2007) A comparison between two electronic apex locators: an ex vivo investigation. Int Endod J. 40(5):362-73. https://doi.org/10.1111/j.1365-2591.2006.01229.x

Duran‐Sindreu F, Gomes S, Stöber E, Mercadé M, Jané L, Roig M (2013) In vivo evaluation of the iPex and Root ZX electronic apex locators using various irrigants. Int Endod J. 46(8):769-74. https://doi.org/10.1111/iej.12057

Ding J, Gutmann JL, Fan B, Lu Y, Chen H (2010) Investigation of apex locators and related morphological factors. J Endod. 36(8):1399-403. https://doi.org/10.1016/j.joen.2010.04.006

Lee SJ, Nam KC, Kim Y-J, Kim DW (2002) Clinical accuracy of a new apex locator with an automatic compensation circuit. J Endod. 28(10):706-9. https://doi.org/10.1097/00004770-200210000-00007

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Published

2023-12-18

How to Cite

Çetinkaya, O. B., Çulha, E., & Aydın, U. (2023). The Accuracy of Different Apex Locator Systems in Detecting Root Perforations in the Presence of Different Irrigation Solutions. European Journal of Therapeutics, 30(1), 39–47. https://doi.org/10.58600/eurjther1936

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