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DOĞAN T, UĞUR AYDIN Z, ALTUNBAŞ D. The Effect of Various Canal Contents on the Accuracy of Two Electronic Apex Locators in Detecting Different Size of Root Perforations. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2021. [DOI: 10.33808/clinexphealthsci.739588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Hanafi A, Donnermeyer D, Schäfer E, Bürklein S. Perception of a modular 3D print model in undergraduate endodontic education. Int Endod J 2020; 53:1007-1016. [PMID: 32220071 DOI: 10.1111/iej.13299] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 03/20/2020] [Indexed: 11/30/2022]
Abstract
AIM To evaluate a modular 3D print training dental model with embedded human teeth and electronic working length determination for undergraduate endodontic education. METHODOLOGY Cone-beam volume tomography data of a human skull were transferred into stereolithographic (STL) data, and a customizable modular 3D print model with individually removable sextants and teeth was generated for the use in commercially available phantom heads. Each of sixty-eight students performed a complete root canal treatment on an extracted human tooth. Working lengths were determined with electronic apex locators (EAL) and verified radiographically. Subsequently, an evaluation was carried out with regard to the difficulty of the working steps access cavity preparation, working length determination, root canal preparation/irrigation and canal filling, and these steps were compared to commonly used benchtop models. Additionally, the agreement of electronic and radiographic working length determination was assessed and analysed statistically with the chi-square test. RESULTS A total of 68 teeth (20 incisors, 26 premolars and 22 molars) with 127 root canals were treated. In total, 87% of the students considered the modular 3D print model considerably more demanding than the conventional benchtop model. Overall, 96% felt better prepared for the clinical situation, 92% felt markedly reduced stress levels during endodontic practice in the subsequent clinical courses, and 93% of the students suggested the model should be used in future preclinical endodontic training. The preradiographic use of EAL resulted in 85% of the cases having radiographically acceptable working length determination within 0-2 mm from the radiographic apex. Readings more than 2 mm from the apex or beyond were significantly more common in molars than in premolars and incisors (P < 0.05). CONCLUSIONS The vast majority of students rated the modular 3D print training model positively despite it being more demanding. They also recommended its use in preclinical teaching and training. The model allowed a more realistic simulation of the clinical situation with a simultaneous use of EALs and led to reduced stress levels in endodontic treatment in the subsequent clinical courses.
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Affiliation(s)
- A Hanafi
- Private Office, Gelsenkirchen, Germany
| | - D Donnermeyer
- Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany
| | - E Schäfer
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
| | - S Bürklein
- Central Interdisciplinary Ambulance in the School of Dentistry, University of Münster, Münster, Germany
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Affiliation(s)
- Jörg Philipp Tchorz
- University Medical Center Freiburg; Faculty of Dentistry, Department of Operative Dentistry and Periodontology; Freiburg Germany
| | - Elmar Hellwig
- University Medical Center Freiburg; Faculty of Dentistry, Department of Operative Dentistry and Periodontology; Freiburg Germany
| | - Markus Jörg Altenburger
- University Medical Center Freiburg; Faculty of Dentistry, Department of Operative Dentistry and Periodontology; Freiburg Germany
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Marroquín BB, Fernández CC, Schmidtmann I, Willershausen B, Goldberg F. Accuracy of electronic apex locators to detect root canal perforations with inserted metallic posts: an ex vivo study. Head Face Med 2014; 10:57. [PMID: 25533476 PMCID: PMC4311483 DOI: 10.1186/s13005-014-0057-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 12/12/2014] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION The detection of possible root canal perforations caused during a metal post placement is frequently difficult to diagnose. The aim of this study was to investigate the accuracy of apex locators to diagnose such perforations. MATERIALS AND METHODS Thirty mesiolingual root canals of extracted mandibular molars were instrumented (30/.04) and a post space was prepared. A root canal perforation was intentionally made at the bi-furcation (n = 15). Metal posts were cemented in 15 perforated and 15 non-perforated root canals. The teeth roots were embedded in an agar-agar solution. The resulting measurements ("short" or "beyond" the apex) disclosed if a perforation could be identified with five different apex locators (ProPex II, Elements Apex Locator, Apex NRG, Raypex 5 and Raypex 6). The sensitivity and specificity (95% interval confidence) were calculated. RESULTS All devices excluded the absence of perforations (100% with 95% confidence interval [78%; 100%] specificity). The Apex NRG and Raypex 6 detected all perforations (100% with 95% confidence interval [78%; 100%] sensitivity). The ProPex II, Elements Apex Locator, and Raypex 5 detected 14 out of 15 perforations (93% with 95% confidence interval [68%; 100%] sensitivity). CONCLUSIONS All devices determined root canal perforations, due to metallic posts, within clinical acceptable ranges.
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Affiliation(s)
- Benjamín Briseño Marroquín
- Department of Operative Dentistry, Johannes Gutenberg University Medical Center, Mainz, Germany. .,Poliklinik für Zahnerhaltung, Langenbeckstr. 1, Mainz, 55131, Germany.
| | | | - Irene Schmidtmann
- Institute of Medical Biometrics, Epidemiology and Informatics, Johannes Gutenberg University Medical Center, Mainz, Germany.
| | - Brita Willershausen
- Department of Operative Dentistry, Johannes Gutenberg University Medical Center, Mainz, Germany.
| | - Fernando Goldberg
- Department of Endodontics, School of Dentistry, USAL-AOA, Buenos Aires, Argentina.
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Jain S, Khaiser IM, Thakur S, Jain S. Restoflex--a revolutionary change in preclinical practice for restorative dentistry and endodontics. J Contemp Dent Pract 2014; 15:359-62. [PMID: 25307821 DOI: 10.5005/jp-journals-10024-1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Preclinical exercises are very important for the dental students in order to master various dental techniques. The objective of this article is to introduce a new preclinical working model named Restoflex. It is especially designed for the students to carry out various restorative and endodontic procedures in an environment that closely simulate clinical situations. This will help them to provide a smooth transition from preclinical environment to the clinical one. It would also mean an increased confidence level and the efficiency with which the students would deal with their cases.
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Affiliation(s)
- Shweta Jain
- Lecturer, Department of Conservative Dentistry and Endodontics, ESIC Dental College and Hospital, Rohini, New Delhi, India, e-mail:
| | - Imran M Khaiser
- Private Practitioner, Department of Conservative Dentistry and Endodontics Bengaluru, Karnataka, India
| | - Sophia Thakur
- Professor, Department of Conservative Dentistry and Endodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Shikha Jain
- Reader, Department of Orthodontics, People's Dental College and Hospital, Bhopal, Madhya Pradesh, India
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Khattak O, Raidullah E, Francis ML. A comparative assessment of the accuracy of electronic apex locator (Root ZX) in the presence of commonly used irrigating solutions. J Clin Exp Dent 2014; 6:e41-6. [PMID: 24596634 PMCID: PMC3935904 DOI: 10.4317/jced.51230] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2013] [Accepted: 09/29/2013] [Indexed: 11/25/2022] Open
Abstract
Objectives: This study aimed to evaluate the accuracy of Root ZX in determining working length in presence of normal saline, 0.2% chlorhexidine and 2.5% of sodium hypochlorite.
Material and Methods: Sixty extracted, single rooted, single canal human teeth were used. Teeth were decoronated at CEJ and actual canal length determined. Then working length measurements were obtained with Root ZX in presence of normal saline 0.9%, 0.2% chlorhexidine and 2.5% NaOCl. The working length obtained with Root ZX were compared with actual canal length and subjected to statistical analysis.
Results: No statistical significant difference was found between actual canal length and Root ZX measurements in presence of normal saline and 0.2% chlorhexidine. Highly statistical difference was found between actual canal length and Root ZX measurements in presence of 2.5% of NaOCl, however all the measurements were within the clinically acceptable range of ±0.5mm.
Conclusion: The accuracy of EL measurement of Root ZX within±0.5 mm of AL was consistently high in the presence of 0.2% chlorhexidine, normal saline and 2.5% sodium hypochlorite.
Clinical significance: This study signifies the efficacy of ROOT ZX (Third generation apex locator) as a dependable aid in endodontic working length.
Key words:Electronic apex locator, working length, root ZX accuracy, intracanal irrigating solutions.
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Affiliation(s)
- Osama Khattak
- Assistant Professor of Endodontics and Co Ordinator Dental Clinics, RAK College of Dental Scineces, Ras al Khaimah, UAE
| | | | - Maria L Francis
- Intern dentist, RAK College of Dental Sciences, Ras al Khaimah, UAE
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Altenburger MJ, Çenik Y, Schirrmeister JF, Wrbas KT, Hellwig E. Combination of apex locator and endodontic motor for continuous length control during root canal treatment. Int Endod J 2009; 42:368-74. [DOI: 10.1111/j.1365-2591.2008.01535.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Erdemir A, Eldeniz AU, Ari H, Belli S, Esener T. The influence of irrigating solutions on the accuracy of the electronic apex locator facility in the Tri Auto ZX handpiece. Int Endod J 2007; 40:391-7. [PMID: 17309740 DOI: 10.1111/j.1365-2591.2007.01234.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIM To determine the influence of various irrigating solutions on the accuracy of the electronic apex locator facility in the Tri Auto ZX handpiece. METHODOLOGY One hundred and forty teeth with single canals and mature apices, scheduled for extraction for either periodontal or prosthetic reasons in 76 patients were used. Following informed written consent local anaesthesia was administered, access cavities were prepared and pulp tissue removed. The teeth were then randomly divided into seven groups according to the irrigating solutions used. The root canal length measurements were completed using the Tri Auto ZX handpiece with automatic reverse function in the presence of one or other of the following solutions: 0.9% saline, 2.5% NaOCl, 3% H(2)O(2), 0.2% chlorhexidine, 17% EDTA, Ultracaine D-S or in the absence of an irrigating solution (control). Files were immobilized in the access cavity with composite resin. After extraction, the apical regions of the teeth were exposed and the file tips examined under a stereomicroscope. Distances between the file tips and the apical constriction were measured (mm) and analysed using a one-way anova and post hoc Tukey test. RESULTS Mean distances from the apical constriction to the file tip were longer in the 0.9% saline group (P<0.05). There was no statistically significant difference on file tip position between the other solutions. CONCLUSIONS Tri Auto ZX gave reliable results with all irrigating solutions apart from in the presence of 0.9% saline.
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Affiliation(s)
- A Erdemir
- Department of Endodontics, Faculty of Dentistry, Kirikkale University, Kirikkale, Turkey.
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Baldi JV, Victorino FR, Bernardes RA, de Moraes IG, Bramante CM, Garcia RB, Bernardineli N. Influence of embedding media on the assessment of electronic apex locators. J Endod 2007; 33:476-9. [PMID: 17368343 DOI: 10.1016/j.joen.2006.12.024] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2006] [Revised: 12/17/2006] [Accepted: 12/24/2006] [Indexed: 11/19/2022]
Abstract
Third-generation electronic apex locators for root canal length determination are very reliable and are not subject to interference from the contents of the canals. This study compared the effectiveness of different embedding media for in vitro assessment of electronic apex locators. The tooth lengths of 30 extracted human mandibular central incisors were measured by introducing a size 15 K-file fitted with a silicone stop into the canal until its tip appeared through the apical foramen; the distance between the tip and stop was measured. The teeth were placed in cylindrical polyethylene tubes filled with different embedding media (1% agar, gelatin, alginate, saline, and flower sponge soaked in saline), and electronic reading was performed with the Root ZX device. Data were statistically assessed by the analysis of variance (ANOVA) and Tukey tests at a significance level of 5%. Despite the lack of statistically significant difference among the media, the flower sponge was the only medium in which the file surpassed the apex in some measurements.
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Affiliation(s)
- Járcio V Baldi
- Department of Endodontics, Bauru Dental School, University of São Paulo, Al. Dr. Otávio Pinheiro Brisolla 9-75, CEP 17012-901 Bauru, SP, Brazil.
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Pommer O, Stamm O, Attin T. Influence of the canal contents on the electrical assisted determination of the length of root canals. J Endod 2002; 28:83-5. [PMID: 11833694 DOI: 10.1097/00004770-200202000-00008] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to compare the influence of the root canal status on the determination of the root canal length by an electronic apex locator in vital and necrotic canals and canals with root canal filling retrieval. One hundred seven teeth with a total of 171 canals with various contents (105 vital pulp, 47 necrotic pulp, and 19 retrieval of root canal filling materials) were measured for root canal length in vivo with the AFA Apex Finder. The distance between the file tip and the radiographic apex was also determined on radiographs. In 86% of the evaluated roots, the file tip position as indicated by the Apex Finder was located within 0.5 mm of a point 1.0-mm short of the radiographic apex. The Apex Finder showed higher accuracy for determining the apical constriction in vital canals (93.9%) than in necrotic canals (76.6%), and this difference was statistically significant (p < or = 0.05). The Apex Finder indicated the point -1 mm +/- 0.5 mm in canals with retrieval of root canal filling materials in 68.4% of these cases, but because of the small number of retrieval cases, this is not comparable statistically with vital and necrotic cases. The authors concluded that the AFA Apex Finder is highly accurate in vital canals.
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Affiliation(s)
- Oliver Pommer
- Department of Operative Dentistry and Periodontology, Freie Universität Berlin, Germany
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Jenkins JA, Walker WA, Schindler WG, Flores CM. An in vitro evaluation of the accuracy of the root ZX in the presence of various irrigants. J Endod 2001; 27:209-11. [PMID: 11487154 DOI: 10.1097/00004770-200103000-00018] [Citation(s) in RCA: 76] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to evaluate the accuracy of the Root ZX in vitro in the presence of a variety of endodontic irrigants. The in vitro model, described by Donnelly, consisted of refrigerated gelatin made with 0.9% sodium chloride instead of water. The following irrigants were tested: 2% lidocaine with 1:100,000 epinephrine, 5.25% sodium hypochlorite, RC Prep, liquid EDTA, 3% hydrogen peroxide, and Peridex. A total of 30 extracted, single-rooted teeth were used. The experimental measurements in the presence of the various irrigants were compared with the actual canal lengths. The present data indicate that the Root ZX electronic apex locator reliably measured canal lengths to within 0.31 mm and that there was virtually no difference in the length determination as a function of the seven irrigants used. These results strongly support the concept that the Root ZX is a useful, versatile, and accurate device for the determination of canal lengths over a wide range of irrigants commonly used in the practice of endodontics.
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Affiliation(s)
- J A Jenkins
- Advanced Education Program, University of Texas Health Science Center at San Antonio, 78229-3900, USA
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Abstract
Conductive gutta-percha master cones (CGPMCs) with a surface conductive silver film have been developed for use with an electronic apex locator. Our research examined the accuracy of these CGPMC placed at working length (WL). Actual canal lengths of 30 extracted anterior teeth with mature apices were determined. Teeth were mounted in an in vitro system and canals step-back prepared. Each CGPMC was seated to the electronic WL as determined by the electronic apex locator and radiographs were made with the CGPMC in this position. Data showed (a) CGPMCs placed with the use of an electronic apex locator were at or within 1 mm short of WL in 36% of the teeth and (b) however, radiographic examination of the same CGPMC placements gave the appearance that 64% were at or within 1 mm short of WL.
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Affiliation(s)
- E M Rivera
- Department of Endodontics, College of Dentistry, University of Iowa, Iowa City
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Abstract
This article describes how to construct and use a simplified model to demonstrate the operation of electronic root canal measuring devices. The model is effective, more economical than those previously described, and uses readily available materials.
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Rivera EM, Seraji MK. Effect of recapitulation on accuracy of electronically determined canal length. ORAL SURGERY, ORAL MEDICINE, AND ORAL PATHOLOGY 1993; 76:225-30. [PMID: 8361736 DOI: 10.1016/0030-4220(93)90209-m] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
The accuracy of an electronic apex locator to measure canal length during instrumentation when nonrecapitulated dentin debris is present has not been evaluated. The purposes of this study were (1) to compare actual with electronic canal length before and after instrumentation, and (2) to compare the accuracy of electronic length in recapitulated and nonrecapitulated canals. Actual canal lengths of 30 mature anterior teeth were determined, teeth mounted in an in vitro system, and canal lengths determined with the electronic apex locator. Canals were step-back prepared to a size 35 file. Fifteen canals were recapitulated and the other 15 were not. Canals were dried and lengths again determined with the electronic apex locator. Data showed that for electronically determined versus actual lengths: 1) 63% were longer, 23% equal, and 13% shorter before instrumentation, 2) 30% were longer, 0% equal, and 70% shorter after instrumentation, 3) instrumentation caused a mean shortening of 0.63 mm, and 4) recapitulation of nonpatent canals was necessary to obtain length reading with the electronic apex locator.
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Affiliation(s)
- E M Rivera
- Department of Endodontics, College of Dentistry, University of Iowa, Iowa City
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Abstract
Because of technical problems and hazards of radiation, dentists have desired alternative ways to determine the working length during root canal therapy. Attention has turned to electronic devices for measuring root canal length. Several such devices are now available. They show promise but their accuracy is hampered because moisture in the root canal can result in inaccurate responses. Recently, a new device, Endex, has been introduced, claiming ease of operation and accuracy in moist environments. Ten operators used the Endex to measure 185 root canal lengths (in 99 teeth). Endex measurements were compared with radiographic measurements. The Endex located the apical constriction accurately within +/- 0.5 mm in 89.64% of moist canals.
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Affiliation(s)
- A L Frank
- Department of Endodontics, School of Dentistry, Loma Linda University, CA 92350
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Fouad AF, Krell KV, McKendry DJ, Koorbusch GF, Olson RA. Clinical evaluation of five electronic root canal length measuring instruments. J Endod 1990; 16:446-9. [PMID: 2098464 DOI: 10.1016/s0099-2399(06)81889-3] [Citation(s) in RCA: 80] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
A previous in vitro study has shown high accuracy, but no clinically significant differences in a group of five electronic root canal length measuring instruments. The purpose of this study was to evaluate and compare the performance of the same group of instruments under clinical conditions and to correlate their accuracy to radiographic estimates of canal length. Five electronic root canal length measuring instruments were used to measure the working length to the "apex" in 20 single-rooted teeth scheduled for extraction. After extraction, the actual canal length was measured visually to a point just within the apical foramen. This length was compared with instrument length as determined electronically. The accuracy of the instruments in determining canal measurement within +/- 0.5 mm from the apical foramen varied from 55 to 75%. The differences between the instruments were not statistically significant. On average, all of the instruments except for the Endocater gave canal length measurements that were beyond the apical foramen. The variability of the measurements, which was comparable to that of estimates of canal length from preoperative radiographs, indicated that radiographic verification of the working length is still desirable.
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Affiliation(s)
- A F Fouad
- College of Dentistry, University of Iowa, Iowa City
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Abstract
Several new root canal length measuring instruments (RCLMI) have recently been introduced claiming superiority over older systems. The purpose of this study was to compare five models of these instruments with respect to their accuracy under a given set of specified conditions. The five RCLMI tested were: the, Exact-a-pex, the Endocater, the Neosono-D, the Apex Finder, and the Sono-Explorer, Mark III. The conditions tested were the accuracy of the instruments in determining the working length, the consistency of measurement following canal instrumentation and with conductive gutta-percha points in place, and the operation of the RCLMI in the presence of fluids frequently found in root canals during endodontic treatment. An in vitro model was used to test these instruments. A set of 20 teeth was tested using the conditions specified above. All data were compared using the mean difference from the actual canal length of the teeth. The results indicated that there were no significant differences among measurements derived from the five instruments, under the specified conditions. There was a slight variation of the measurements by all instruments when they were used following instrumentation and with the use of conductive gutta-percha points. When fluids were present in the canals, the reliability of the RCLMI depended on the electrical conductivity of the fluid tested. The poorest results were obtained when either sodium hypochlorite or blood were present in the canals.
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Endodontic References. Int Endod J 1988. [DOI: 10.1111/j.1365-2591.1988.tb00951.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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