In vivo assessment of accuracy of Propex II, Root ZX II, and radiographic measurements for location of the major foramen

How Do Different Image Modules Impact the Accuracy of Working Length Measurements in Digital Periapical Radiography? An In Vitro Study

Background/Objectives: This study aims to evaluate the accuracy of digital dental radiography in determining working length in root canal treatment via various image modules. Methods: A total of 40 intact single-rooted, single-canal human premolar teeth were examined. Following meticulous cleaning, the teeth were placed in a maxillary premolar socket within a dry human skull. X-ray images were systematically captured via a Carestream RVG digital sensor under standardized conditions. The digital images are processed under five distinct image modules: 1. original module, 2. autoenhancement module, 3. autoenhancement+negative module, 4. negative module, 5. colored module. Three calibrated observers determined the working length of each digital radiograph after the specified image modules were applied. The agreement between the actual working length and the lengths determined by the observers was evaluated via Pearson correlation analysis. A significance level of 0.05 was set for the statistical tests. Results: A high level of intra- and interobserver agreement, with a strong correlation between the actual measurements and all image module groups, was obtained (p < 0.001). The original image module group demonstrated the highest compatibility (ICC = 0.940, r = 0.912), whereas the colored image module group exhibited the lowest compatibility (ICC = 0.924, r = 0.879) with the actual measurement. Conclusions: This study demonstrates the accuracy of digital radiography in determining working length through the application of various image modules, with the original image module exhibiting the closest alignment to actual working lengths. These findings support the continued use and further development of computer-based image processing tools to optimize clinical outcomes in root canal therapy.

Influence of maintaining apical patency in post-endodontic pain

BACKGROUND

The concept of instrumentation beyond the apical foramen by small flexible file to prevent apical blockage is apical patency. However, this procedure might endow postoperative pain, thus to maintain apical patency or not is the matter of dilemma. Hence, the primary objective of this study was to compare postoperative pain between apical patency and non-patency groups and secondary objective was to evaluate the influence of number of visits, vitality of teeth, group of teeth and preoperative pain on post-operative pain.

METHODS

Preselected (n = 178) patients based on group of teeth and status of pulp were randomly divided into 2 groups, apical patency and non-patency which was further treated in either single or multiple visits. After exclusion, 160 patients were included. Each group (n = 80) was subdivided in single visit (n = 40) and multiple visits (n = 40), including vital (n = 20) and non-vital teeth (n = 20) and single-rooted (n = 10) and multiple-rooted teeth (n = 10). Apical patency was maintained with a size 10 K-file during conventional hand filing step-back shaping procedure. Intensity of pain was recorded before treatment and on days 1, 2, and 7 after treatment using Numerical Rating Scale (NRS-11). Statistical analysis was done using Mann-Whitney U test, Spearman correlation and Multiple linear regression analysis.

RESULTS

The primary outcome of this study showed statistically significant difference (p < 0.05) in postoperative pain scores between patency and non-patency groups with higher pain scores in patency group on 1st, 2nd and 7th day follow up. The secondary outcome showed postoperative pain in patency-maintained group was influenced by status of the pulp and preoperative pain only. Vital teeth of patency-maintained group treated in multiple visits showed statistically significant (p = 0.02) post-operative pain in day 1 follow up. Pre-operative pain showed positive correlation with postoperative pain with statistically significant difference.

CONCLUSIONS

Our study concluded that maintenance of apical patency increased postoperative pain. Evaluation of influence of number of visits, status of pulp, group of tooth and preoperative pain revealed status of pulp and preoperative pain as influencing factors for postoperative pain in patency group.

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.

Comparison of the accuracy of conventional and digital radiography in root canal working length determination: An invitro study

Background. Digital radiography has widespread use in endodontics. Determining a correct working length is vital for a proper endodontic therapy. The aim of this study was to compare the accuracy of conventional and digital radiographic techniques for root canal working length determination.

Methods. After determining the real working lengths of 50 permanent maxillary central incisors (gold standard), the conventional (E- and F-speed films) and digital (CCD, PSP) images were obtained using the parallel technique. The mean registered working length of each modality was compared with the other and with the gold standard using one-way ANOVA at P<0.05.

Results. No significant difference was found between the recorded working length values using the conventional and digital radiographic techniques (P=0.828).

Conclusion. Within the limitations of this study, it was concluded that there was no difference between the measurement accuracy of CCD, PSP and conventional imaging techniques in root canal working length determination.