•  
  •  
 

ORCID ID

Merve Yeniçeri Özata : 0000-0003-3619-3118

Seda Falakaloğlu : 0000-0001-5230-969X

Sadullah Kaya : 0000-0002-4644-0058

Abstract

Background: One of the significant stages during endodontic procedures is determining the correct working length (WL). This study aimed to evaluate the accuracy of four electronic apex locators (EALs) (Root ZX mini, Raypex 6, Propex Pixi, and E-Pex Pro) and cone-beam computed tomography (CBCT) and radiographic measurement in determining the actual WL (A-WL).

Methods: Thirty extracted single-root mandibular premolars were selected and flattened at the crown. The WL was determined by advancing the #15 K file until its tip was visible from the apical, and the A-WL was established by subtracting 0.5 mm from this length. The WL was also determined using periapical radiography, four EALs, and CBCT. The differences in all measurements were compared with the A-WL. The data were statistically analyzed using one-way analysis of variance (Welch) and Tamhane’s test. The significance level was set at p < 0.05.

Results: Compared with other measurement methods, CBCT gave shorter values than the A-WL, and this finding was statistically significant compared with those of the PR and Propex Pixi groups (p = 0.009) (p = 0.024). No significant difference was observed between the other groups (p > 0.05) except the CBCT group (p < 0.05).

Conclusions: Root ZX mini and Raypex 6 made measurements close to the A-WL.

References

  1. Ricucci D. Apical limit of root canal instrumentation and obturation, part 1. Literature review. Int Endod J. 1998;31:384–93.
  2. Sheaffer JC, Eleazer PD, Scheetz JP, Clark SJ, Farman AG. Endodontic measurement accuracy and perceived radiograph quality: Effects of film speed and density. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2003;96:441–8.
  3. Krishnan IS, Sreedharan S. A comparative evaluation of electronic and radiographic determination of root canal length in primary teeth: An in vitro study. Contemp Clin Dent. 2012;3:416–20.
  4. Stein TJ, Corcoran JF. Radiographic “working length” revisited. Oral Surg Oral Med Oral Pathol. 1992;74:796–800.
  5. Real DG, Davidowicz H, Moura-Netto C, Zenkner CdLL, Pagliarin CML, Barletta FB, et al. Accuracy of working length determination using 3 electronic apex locators and direct digital radiography. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 201;111:e44–9.
  6. Voorde HV, Bjorndahl AM. Estimating endodontic “working length” with paralleling radiographs. Oral Surg Oral Med Oral Pathol. 1969;27:106–10.
  7. Williams CB, Joyce AP, Roberts S. A comparison between in vivo radiographic working length determination and measurement after extraction. J Endod. 2006;32:624–7.
  8. Estrela C, Bueno MR, Sousa-Neto MD, Pécora JD. Method for determination of root curvature radius using cone-beam computed tomography images. Braz Dent J. 2008;19:114–8.
  9. Kolanu SK, Bolla N, Varri S, Thummu J, Vemuri S, Mandava P. Evaluation of correlation between apical diameter and file size using Propex Pixi apex locator. J Clin Diag Res. 2014;8:ZC18–20.
  10. Gordon M, Chandler N. Electronic apex locators. Int Endod J. 2004;37:425–37.
  11. Stoll R, Urban‐Klein B, Roggendorf M, Jablonski‐Momeni A, Strauch K, Frankenberger R. Effectiveness of four electronic apex locators to determine distance from the apical foramen. Int Endod J. 2010;43:808–17.
  12. VDW-Dental. Raypex 6 Brochure. VDW GmbH: Munich.
  13. Lucena C, López J, Martín J, Robles V, González‐Rodríguez M. Accuracy of working length measurement: Electronic apex locator versus cone‐beam computed tomography. Int Endod J. 2014;47:246–56.
  14. Pratten DH, McDonald N. Comparison of radiographic and electronic working lengths. J Endod. 1996;22:173–6.
  15. Haffner C, Folwaczny M, Galler K, Hickel R. Accuracy of electronic apex locators in comparison to actual length-an in vivo study. J Dent. 2005;33:619–25.
  16. Plotino G, Grande N, Brigante L, Lesti B, Somma F. Ex vivo accuracy of three electronic apex locators: Root ZX, Elements Diagnostic Unit and Apex Locator and ProPex. Int Endod J. 2006;39:408–14.
  17. da Silva TM, Alves FR. Ex vivo accuracy of Root ZX II, Root ZX Mini and RomiApex A-15 apex locators in extracted vital pulp teeth. J Contemp Dent Pract. 2014;15:312–14.
  18. 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. 2020;46:158–61.
  19. Üstün Y, Aslan T, Şekerci AE, Sağsen B. 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. 2016;42:1334–7.
  20. Yılmaz F, Kamburoğlu K, Şenel B. Endodontic working length measurement using cone-beam computed tomographic images obtained at different voxel sizes and field of views, periapical radiography, and apex locator: A comparative ex vivo study. J Endod. 2017;43:152–6.
  21. Connert T, Hülber‐J M, Godt A, Löst C, ElAyouti A. Accuracy of endodontic working length determination using cone beam computed tomography. Int Endod J. 2014;47:698–703.
  22. Connert T, Judenhofer M, Hülber‐J M, Schell S, Mannheim J, Pichler B, et al. Evaluation of the accuracy of nine electronic apex locators by using Micro‐CT. Int Endod J. 2018;51:223–32.
  23. Piasecki L, Carneiro E, da Silva Neto UX, Westphalen VPD, Brandão CG, Gambarini G, et al. The use of micro–computed tomography to determine the accuracy of 2 electronic apex locators and anatomic variations affecting their precision. J Endod. 2016;42:1263–7.
  24. Piasecki L, Dos Reis PJ, 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;44:1872–7.
  25. Martins JN, Marques D, Mata A, Caramês J. Clinical efficacy of electronic apex locators: Systematic review. J Endod. 2014;40:759–77.
  26. Savani GM, Sabbah W, Sedgley CM, Whitten B. Current trends in endodontic treatment by general dental practitioners: Report of a United States national survey. J Endod. 2014;40:618–24.
  27. Mancini M, Felici R, Conte G, Costantini M, Cianconi L. Accuracy of three electronic apex locators in anterior and posterior teeth: An ex vivo study. J Endod. 2011;37:684–7.
  28. Janner SF, Jeger FB, Lussi A, Bornstein MM. Precision of endodontic working length measurements: A pilot investigation comparing cone-beam computed tomography scanning with standard measurement techniques. J Endod. 201;37:1046–51.
  29. Sherrard JF, Rossouw PE, Benson BW, Carrillo R, Buschang PH. Accuracy and reliability of tooth and root lengths measured on cone-beam computed tomographs. Am J Orthod Dentofac Orthop. 2010;137:S100–8.
  30. Cianconi L, Angotti V, Felici R, Conte G, Mancini M. Accuracy of three electronic apex locators compared with digital radiography: An ex vivo study. J Endod. 2010;36:2003–7.
  31. Briseño-Marroquín B, Frajlich S, Goldberg F, Willershausen B. Influence of instrument size on the accuracy of different apex locators: An in vitro study. J Endod. 2008;34:698–702.
  32. Aydin U, Karataslioglu E, Aksoy F, Yildirim C. In vitro evaluation of Root ZX and Raypex 6 in teeth with different apical diameters. J Conserv Dent. 2015;18:66.
  33. Topuz Ö, Uzun Ö, Tınaz AC, Sadik B. Accuracy of the apex locating function of TCM Endo V in simulated conditions: A comparison study. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 2007;103:e73–6.
  34. Lipski M, Trąbska‐Świstelnicka M, Woźniak K, Dembowska E, Droździk A. Evaluation of alginate as a substitute for root‐surrounding tissues in electronic root canal measurements. Aust Endod J. 2013;39:155–8.

Creative Commons License

Creative Commons Attribution-Share Alike 3.0 License
This work is licensed under a Creative Commons Attribution-Share Alike 3.0 License.

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.