Comparative evaluation of accuracy of two electronic apex locators in the presence of various irrigants: An in vitro study

Ex vivo evaluation of the accuracy of four electronic foraminal locators

Background

To evaluate the accuracy of four different Electronic Foraminal Locators (EFLs): Root ZX II (J. Morita, Tokyo, Japan), Romiapex A15 (Romidan, Kiryat-Ono, Israel), FinePex (Schuster, Porto Alegre, Brazil), and VDW Gold (VDW, Munich, Germany), in determining root canal length.

Material and Methods

Twenty-seven human single-rooted teeth had their crowns sectioned at the cementoenamel junction, and the actual length of the tooth was obtained by visualizing with an operative microscope a #15 file placed adjacent to the apical foramen. The teeth were instrumented with R25 and R40 files, and at the end of each instrumentation, measurements of the lengths of the root canals were made with #25 and #40 files. The data were statistically analyzed by ANOVA and chi-square tests and were considered significant when P<0.05. All devices showed a tendency to underestimate measurements by 0.25 mm diameter.

Results

The mean accuracy of the Root ZX II appliance was statistically lower than the other EFLs (P<0.001). For the 0.40 mm diameter, the mean accuracy of the Romiapex A15 appliance was statistically higher than the other LEFs (P<0.001). However, when the diameter was 0.40 mm, only the Romiapex A15 device tended to overmeasure. Regarding the acceptable limits of variation, it was observed that the devices showed similar efficiency in determining odontometry (P>0.05), both with diameters of 0.25 mm and 0.40 mm.

Conclusions

It was concluded that the devices presented similar and adequate efficacy when observing the limits of acceptable measurements. It was observed that increasing the apical diameter did not influence the accuracy of EFLs in determining root canal lengths. Key words:Endodontics, working length, electronic foraminal locators, endodontic treatment.

Comparative evaluation of working length determined using integrated apex locator and root ZX mini under various irrigating solutions: An in vivo study

Background

Electronic apex locators (EALs) are frequently used as adjuvant to radiographs in working length (WL) determination. The introduction of integrated apex locators (IALs) further simplified the root canal treatment by continuous monitoring of the apex while root canal shaping.

Aim

The aim of this study was to evaluate the efficacy of radiographs, EAL, and IAL in determining the WL in the presence of various irrigants.

Materials and Methods

The present in vivo study was carried out on 30 patients who were divided into 10 in each group, based on the type of irrigant used; 0.9% saline (Group 1), 0.2% chlorhexidine (Group 2), and 2.5% of sodium hypochlorite (NaOCL) (Group 3). In each group, WL is determined using conventional radiographs, Root ZX Mini (EAL), and CanalPro CL2i (IAL).

Statistical Analysis

Kruskal-Wallis test and Friedman's two-way ANOVA test were used for statistical analysis.

Results

Mean WL was comparably lower with Root ZX Mini, while the WL by CanalPro CL2i and the radiographic method were comparable. In all methods, the type of solutions used did not influence the WL, with a higher mean WL when NaOCL is used as an irrigant. Nevertheless, the above comparisons were not statistically significant.

Conclusion

the irrigation solutions employed in this study had no impact on the performance of apex locators and radiographs.

Blood-Derived Biomaterial for Catheter-Directed Arterial Embolization

Vascular embolization is a life-saving minimally invasive catheter-based procedure performed to treat bleeding vessels. Through these catheters, numerous metallic coils are often pushed into the bleeding artery to stop the blood flow. While there are numerous drawbacks to coil embolization, physician expertise, availability of these coils, and their costs further limit their use. Here, a novel blood-derived embolic material (BEM) with regenerative properties, that can achieve instant and durable intra-arterial hemostasis regardless of coagulopathy, is developed. In a large animal model of vascular embolization, it is shown that the BEM can be prepared at the point-of-care within 26 min using fresh blood, it can be easily delivered using clinical catheters to embolize renal and iliac arteries, and it can achieve rapid hemostasis in acutely injured vessels. In swine arteries, the BEM increases cellular proliferation, angiogenesis, and connective tissue deposition, suggesting vessel healing and durable vessel occlusion. The BEM has significant advantages over embolic materials used today, making it a promising new tool for embolization.

The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators

Background

Accurate determination of working length (WL) is crucial for the success of endodontic therapy. The aim of this study was to determine the influence of 2% chlorhexidine digluconate solution, 2% chlorhexidine digluconate gel and 2% hypochlorite solution on the accuracy of two devices: the Raypex 5 and the ApexDal.

Methods

Twenty-nine single-rooted human teeth were used in this study. The crowns were cut horizontally and embedded in an alginate mass. In each tooth, six endodontic measurements were made using two electronic apex locators (EALs): a Raypex 5 and an ApexDal. For each EAL, measurements were taken with the following products: 2% chlorhexidine solution (CHX-S group), 2% chlorhexidine gel (CHX-G group) and 2% NaOCl (NaOCl group). After performing an endodontic measurement, the endodontic instruments were stabilized with flow resin composite. Afterwards, the roots were removed from the alginate mass, and the apical one-third of each root was cut lengthways to recover the canal system. Last, the distance between the file tip and the apical foramen was measured under a microscope at 60 x magnification.

Results

Statistically significant differences were found between CHX-S and NaOCl and CHX-G and NaOCl, but no significant differences were detected between CHX-S and CHX-G during the testing of both devices. No statistically significant differences were observed between the Raypex 5 and ApexDal for all intracanal media tested.

Conclusion

The EALs Raypex 5 and ApexDal had higher accuracy in the anatomical foramen of the root containing chlorhexidine in the gel or in the solution form than in the canal containing sodium hypochlorite.

Comparative Evaluation of Accuracy of Two Electronic Apex Locators in the Presence of Contemporary Irrigants: An In vitro Study

Aim:

The present study was aimed to compare the accuracy of Root ZX Mini and Propex II in the presence of 0.1% octinidine dohydrochloride (OCT), 2% chlorhexidine gluconate (CHX), and 5% sodium hypochlorite (NaOCl) heated and nonheated before and after preparation.

Materials and Methods:

Eighty extracted single-rooted teeth were selected for the study and decoronated. Teeth were mounted in an alginate model. Actual working length (AL) was measured using a stereomicroscope under ×4 magnification. Electronic working length measurements were recorded using Root ZX Mini and Propex II apex locators in the presence of 0.1% OCT, 2% CHX, and 5% NaOCl (nonheated and heated to 60°C) before and after preparation. Mean and standard deviation differences before and after preparation were calculated and statistically analyzed using analysis of variance and paired t-test.

Results:

The accuracy of Root ZX Mini before and after preparation within ±0.5 mm of AL was consistently high in the presence of irrigants than Propex II. 5% NaOCl (heated and nonheated) showed more variation than the other irrigants, in the working length determination in both the apex locators.

Conclusion:

Electronic length measurements were shorter with heated and nonheated 5% NaOCl and longer with 0.1% OCT and 2% CHX for both the electronic apex locators.

An Invitro Evaluation of the Accuracy of Two Electronic Apex Locators to Determine Working Length in the Presence of Various Irrigants

Background

Cleaning and shaping of root canal system requires various irrigating solutions. The question is whether the presence of irrigation solution alters working length determination using apex locators. The purpose of this study was to compare the accuracy of Root ZX and i-Root apex locator for determining working length in the presence of different irrigating solution.

Materials and Method

Eighty extracted single rooted human teeth were used. The teeth were sectioned at Cemento Enamel Junction (CEJ) and actual canal length determined. Then, working length measurements were obtained using Root ZX and i-Root apex locator in the presence of irrigating solutions namely 0.9% saline, 3% of sodium hypochlorite (NaOCl), 2% chlorhexidine digluconate(CHX) and 17% Ethylene Diamine Tetra Acetic acid (EDTA). The measurements obtained with Root ZX and i-Root apex locator were compared with actual canal length and subjected to statistical analysis using Post Hoc Test Tukey's Method.

Results

This study revealed that both the tested Electronic apex locators (EAL) were able to measure the canal length in the presence of tested irrigating solutions. The presence of irrigating solutions of saline, NaOCl, chlorhexidine and EDTA in the root canal marginally influenced the accuracy of the Root ZX or i-Root (P < 0.36), but with no clinical significance.

Conclusion

Root ZX and i-Root can be used safely to determine working length in the presence of various irrigants. The content of the root canal did not influence the accuracy while measuring working length using Electronic apex locators (EAL)

The role of titanium-prepared platelet-rich fibrin in palatal mucosal wound healing and histoconduction

OBJECTIVE

We aimed to determine the clinical effects of titanium-prepared, platelet-rich fibrin (T-PRF) on human palatal mucosal wound healing (PMWH) and to identify its effect on time-dependent changes in palatal soft-tissue thickness (PSTT) in terms of histoconduction, which is a new concept.

MATERIALS AND METHODS

Free gingival graft (FGG) donor sites were treated with T-PRF and compared with an untreated control group. The results of colour match and H₂O₂-bubbling tests for complete wound epithelization (CWE) were recorded on days 3, 7, 14 and 21. Pain level, number of analgesics used and bleeding status were recorded for the first 7 days. PSTT was measured at baseline and after 1 and 6 months.

RESULTS

Colour match scores of the test group were significantly higher than those of the control group at 7 and 14 days. CWE was observed at a higher frequency in the test group than in the control group on day 14. Post-operative bleeding prevalence was lower in the test group than in the control group for the first 2 days. A time-dependent decrease in PSTT was observed at 1 and 6 months in the control group compared with baseline (baseline, 4.23 ± 0.62 mm; 1 month, 4.01 ± 0.68 mm; and 6 months, 3.93 ± 0.69 mm). However, no significant difference was found in the test group (baseline, 4.29 ± 0.64 mm; 1 month, 4.61 ± 0.51 mm; and 6 months, 4.51 ± 0.58 mm).

CONCLUSION

The T-PRF membrane exhibited positive effects on PMWH. T-PRF, which is a promising autogenous matrix for histoconduction, may also be preferred as an autogenous alternative to connective tissue grafts in the treatment of gingival recessions and peri-implant mucosal recessions.