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Siddiqui AY. Influence of Embedding Medium on iPex Electronic Apex Locator Accuracy: An Ex Vivo Comparative Study Using Alginate, Saline, and Gelatin Models. J Contemp Dent Pract 2023; 24:733-738. [PMID: 38152904 DOI: 10.5005/jp-journals-10024-3583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
AIM Accurate working length determination during root canal treatment is essential for achieving successful outcomes. This study aimed to evaluate the impact of embedding medium on the accuracy of iPex electronic apex locator (EAL). MATERIALS AND METHODS Sixty-one extracted single-rooted teeth were decoronated and coronally flared with Gates-Glidden burs. Actual canal length (ACL) was obtained by introducing a size 8 K-file until its tip reached the most coronal border of the apical foramen. This step was performed thrice and then averaged. Deducting 0.5 mm from the ACL provided the working length (WL). The teeth were randomly placed in plastic containers filled with freshly mixed alginate, gelatin, or saline, with the lip clip placed in the medium. The blinded operator obtained electronic measurements using iPex by advancing a K-file with a size compatible with the canal attached to the file clip and advanced until the 0.0 mark, then withdrawn to the 0.5 mark. This step was performed thrice and then averaged. Data were analyzed using ANOVA and Tukey's post hoc test, with significance level set at 5% (α = 0.05). RESULTS The mean difference between WL and iPex length obtained in the gelatin model was significantly longer than the difference with mean iPex length in alginate (p = 0.005) and in saline (p < 0.001). There was no significant difference between iPex readings obtained in alginate and saline (p = 0.249). CONCLUSION The use of freshly mixed alginate or saline for ex vivo assessment of iPex is recommended, whereas the use of gelatin could increase the chances of readings longer than looked for. CLINICAL SIGNIFICANCE Identifying the optimum embedding medium for ex vivo testing of EALs permits the comparison and assessment of several factors affecting EALs' precision under standardized conditions. This helps in understanding EAL performance in vivo and in optimizing its clinical utilization.
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Affiliation(s)
- Amna Y Siddiqui
- Department of Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia, Phone: +966555531081, e-mail: , https://orcid.org/0000-0003-0817-7129
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Karunakar P, Reddy MSR, Faizuddin U, Priya PS, Karteek BS, Saideep CV. Comparative evaluation of working length determined using integrated apex locator and root ZX mini under various irrigating solutions: An in vivo study. J Conserv Dent Endod 2023; 26:590-594. [PMID: 38292354 PMCID: PMC10823966 DOI: 10.4103/jcde.jcde_68_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 02/01/2024]
Abstract
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.
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Affiliation(s)
- P. Karunakar
- Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - M. S. Ranga Reddy
- Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Umrana Faizuddin
- Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - P. Shanti Priya
- Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Basa Srinivas Karteek
- Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Chada Venkata Saideep
- Department of Conservative Dentistry and Endodontics, Panineeya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
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Davalbhakta RN, Gokhale NS, Hugar SM, Badakar CM, Gowtham A, Soneta SP. Comparative evaluation of root ZX Mini® apex locator and radiovisiography in determining the working length of primary molars: An In Vivo study. J Oral Biol Craniofac Res 2021; 11:257-262. [PMID: 33680750 PMCID: PMC7918273 DOI: 10.1016/j.jobcr.2021.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/02/2021] [Accepted: 02/10/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Working length determination is a crucial step for success of pulpectomy. Various new modalities have been developed. The newest technology includes EAL. Electronic apex locators require less chair side time, do not produce pain and avoid unnecessary radiation which makes it more superior in paediatric endodontic procedures. AIM To evaluate and compare Root ZX mini apex locator and Radiovisiography (RVG) for determining working length in primary molars. MATERIALS AND METHODS A sample of 30 primary molar teeth was subjected to working length determination by Root ZX mini and RVG. The data was collected and then tabulated and subjected to statistical analysis. RESULTS On comparison among two groups, it was found there was no difference between the efficiency of modalities. A positive correlation was seen among Root ZX mini and RVG (ICC = 0.99). CONCLUSION Root ZX mini and radiovisiography are seen to be precise in determination of working length in primary molars. It can be said that Root ZX mini i. e the electronic apex locators can be used as an adjunct to Radiovisiography and conventional radiography.
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Affiliation(s)
- Rucha N. Davalbhakta
- Department of Pedodontics and Preventive Dentistry, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences, Belagavi, India
| | - Niraj S. Gokhale
- Department of Pedodontics and Preventive Dentistry, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences, Belagavi, India
| | - Shivayogi M. Hugar
- Department of Pedodontics and Preventive Dentistry, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences, Belagavi, India
| | - Chandrashekhar M. Badakar
- Department of Pedodontics and Preventive Dentistry, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences, Belagavi, India
| | - A. Gowtham
- Department of Pedodontics and Preventive Dentistry, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences, Belagavi, India
| | - Sanjana P. Soneta
- Department of Pedodontics and Preventive Dentistry, KLE Academy of Higher Education and Research, KLE VK Institute of Dental Sciences, Belagavi, India
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Golvankar K, Kader MA, Latheef AA, Ali ABM, Abullais SS, Sibagathullah M. Comparison of Accuracy in Determining the Root Canal Working Length by Using Two Generations of Apex Locators - An In Vitro Study. Open Access Maced J Med Sci 2019; 7:3276-3280. [PMID: 31949530 PMCID: PMC6953924 DOI: 10.3889/oamjms.2019.696] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 11/17/2022] Open
Abstract
AIM The present in-vitro study aims to compare the accuracy of root canal working length determination between the third generation and fourth generation electronic apex locators. MATERIAL AND METHODS Fifty extracted single-rooted single canal teeth were selected for the study, and a definite coronal plane was prepared. Actual working length (AL) was measured using a stereomicroscope under 8X magnification. Electronic working length measurements were recorded using Root ZX (EL1) and Elements Diagnostic Unit (EL2) apex locators. One-way ANOVA test was carried out to analyse the data among the experimental groups. RESULTS The results of the one-way ANOVA test showed that difference in the working length determined by either apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant. The independent 't' test comparing between groups EL1 and AL; and EL2 and AL showed that working length determined by either of the apex locators (EL1 and EL2) and actual length determined under a stereomicroscope (AL) was statistically not significant. CONCLUSION In this in vitro study, the Root ZX and Elements Diagnostic Unit apex locators are equally accurate for determination of working length when compared to actual working length.
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Saraf PA, Ratnakar P, Patil TN, Penukonda R, Kamatagi L, Vanaki SS. A comparative clinical evaluation of accuracy of six apex locators with intraoral periapical radiograph in multirooted teeth: An in vivo study. J Conserv Dent 2017; 20:264-268. [PMID: 29259365 PMCID: PMC5721510 DOI: 10.4103/jcd.jcd_131_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Revised: 11/02/2017] [Accepted: 11/07/2017] [Indexed: 11/16/2022] Open
Abstract
AIM The purpose of this clinical study was to compare and clinically, to evaluate the accuracy of six apex locators with intra oral periapical (IOPA) radiograph in multirooted teeth. MATERIALS AND METHODS A total of 90 multirooted teeth (maxillary and mandibular molars) with irreversible, infected or necrotic pulp tissue and completely formed roots were included in this study and were divided randomly into six groups (Root ZX II, Raypex 6, I-Root, Romiapex A-15, Sybron Endo Mini and Root ZX mini). The working length was determined using six different apex locators, and the accuracy of the apex locators was compared with IOPA radiographs, to be categorized as accurate, short, and long or beyond. RESULTS A total of 270 canals were evaluated, of which 233 (86.3%) canals exhibited acceptable working length, 28 (10.4%) canals exhibited short working length, and only 9 (3.3%) canals exhibited working length beyond the apex. There were a statistically significant results in all the groups (P < 0.05) and the comparison between the groups was statistically insignificant. CONCLUSION The repeatability with that of apex locators is of great advantage, but the information gained from the radiographs cannot be obtained by any other means. Therefore, it is recommended that radiograph and apex locators are the best combinations in accurately determining the working length and the successful endodontics.
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Affiliation(s)
- Prahlad A. Saraf
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - P. Ratnakar
- Department of Conservative Dentistry and Endodontics, H. K. E. Society's S. N Institute of Dental Science and Research, Gulbarga, Karnataka, India
| | - Thimmanagowda N. Patil
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Raghavendra Penukonda
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Laxmikant Kamatagi
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
| | - Sneha S. Vanaki
- Department of Conservative Dentistry and Endodontics, PMNM Dental College and Hospital, Bagalkot, Karnataka, India
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Abdullah A, Singh N, Rathore MS, Tandon S, Rajkumar B. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo. Int J Clin Pediatr Dent 2016; 9:118-23. [PMID: 27365931 PMCID: PMC4921879 DOI: 10.5005/jp-journals-10005-1346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Accepted: 12/12/2015] [Indexed: 11/23/2022] Open
Abstract
AIMS The aim of this study was to evaluate the effectiveness of two different varieties of electronic apex locators and radiovisiography (RVG) for working length determination in primary teeth. MATERIALS AND METHODS A total of 30 primary teeth indicated for pulpectomy in children aged 3 to 8 years were randomly selected and subjected to working length determination using two varieties of electronic apex locators and RVG separately. The data were then subjected to statistical analysis. RESULTS A very strong correlation between electronic measurement methods and RVG length was observed. CONCLUSION Radiovisiography and apex locators are equally effective in determining working length in primary teeth. How to cite this article: Abdullah A, Singh N, Rathore MS, Tandon S, Rajkumar B. Comparative Evaluation of Electronic Apex Locators and Radiovisiography for Working Length Determination in Primary Teeth in vivo. Int J Clin Pediatr Dent 2016;9(2):118-123.
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Affiliation(s)
- Ahsan Abdullah
- Senior Lecturer, Department of Pedodontics and Preventive Dentistry Post Graduate Institute of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Neerja Singh
- Professor, Department of Pedodontics and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Monika S Rathore
- Professor, Department of Pedodontics and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Shobha Tandon
- Professor, Department of Pedodontics and Preventive Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Balakrishnan Rajkumar
- Professor, Department of Endodontics and Conservative Dentistry, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
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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 Diagn Res 2014; 8:ZC18-20. [PMID: 25654023 DOI: 10.7860/jcdr/2014/9307.5247] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 08/16/2014] [Indexed: 11/24/2022]
Abstract
AIM AIM of this study is to evaluate the influence of critical diameter of apical foramen and file size using propex pixi apex locator in working length determination. MATERIALS AND METHODS In this study, ten single rooted teeth were selected. They were decoronated at cemento enamel junction. After determining the actual working length, they were embedded in alginate mold. Foramina were widened from 0.6mm to 0.8mm. The measurements were taken with electronic apex locator propex pixi with files from sizes 10 K to respective sizes. Statistical accuracy of propex pixi was calculated by using Anova test for different diameters and for the influence of file size. RESULTS RESULTS showed that propex pixi apex locator was accurate when foramen diameter is 0.6 (60k file size), its accuracy diminished with increased foramen diameter CONCLUSION Propex pixi is accurate for foramen diameter of 0.6mm, independent of file size. Its accuracy decreases as apical foramen widens, so care should be taken when using clinically.
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Affiliation(s)
- Sreeha Kaluva Kolanu
- Post Graduate, Master of Dental Surgery in Speciality of Conservative Dentistry & Endodontics, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Nagesh Bolla
- Head of the Department, Master of Dental Surgery in Speciality of Conservative Dentistry & Endodontics, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Sujana Varri
- Professor, Master of Dental Surgery in Speciality of Conservative Dentistry & Endodontics, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Jayaprakash Thummu
- Professor, Master of Dental Surgery in Speciality of Conservative Dentistry & Endodontics, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Sayesh Vemuri
- Professor, Master of Dental Surgery in Speciality of Conservative Dentistry & Endodontics, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India
| | - Pragna Mandava
- Sr. Lecturer, Master of Dental Surgery in Speciality of Conservative Dentistry & Endodontics, Sibar Institute of Dental Sciences , Guntur, Andhra Pradesh, India
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D'Assunção FLC, Sousa JCN, Felinto KCA, de Medeiros TC, Leite DT, de Lucena RB, de Oliveira Lima J. Accuracy and repeatability of 3 apex locators in locating root canal perforations: an ex vivo study. J Endod 2014; 40:1241-4. [PMID: 25069941 DOI: 10.1016/j.joen.2014.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 02/05/2014] [Accepted: 02/08/2014] [Indexed: 11/26/2022]
Abstract
INTRODUCTION This study was an ex vivo evaluation of the accuracy and repeatability of 3 electronic apex locators (EALs) in locating simulated root canal perforations. METHODS Thirty-five human teeth were used. Perforations were placed 5 mm from the apex of each specimen. A #15 K-file was attached to a micrometer, and the specimens were fixed in a mounting model. The EALs were connected to the files, and electronic measurements of the simulated perforations were obtained. This procedure was repeated, the files were cemented in place, and x-rays were obtained to evaluate the distances between the measurement files and the simulated perforations. The obtained results were compared with the corresponding control lengths. Three investigators evaluated the distance of the file position in relation to the perforation for each specimen. The 3 investigators reached consensus regarding these measurements. RESULTS Statistical analyses of the results revealed that the EAL reliabilities in the exact detections of the root canal perforations were 97.1% for the Mini Apex Locator, 100% for the Root SW, and 91.4% for the Root ZX II. Analysis of variance revealed that the accuracies of the 3 devices were not different (P > .05). The results also indicated high levels of repeatability for each of the 3 EALs (intraclass correlation coefficients: 0998, 0.999, and 0.999 for the Mini Apex Locator, Root SW, and Root ZX II, respectively). CONCLUSIONS It was concluded that each of these 3 EALs provided excellent ex vivo accuracy in locating root perforations and that all tested devices possess excellent ex vivo repeatability.
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Affiliation(s)
| | | | | | | | - Diego Tavares Leite
- Department of Endodontics Restorative Dentistry, Federal University of Paraiba, Paraiba, Brazil
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Khursheed I, Bansal R, Bansal T, Singh HP, Yadav M, Reddy KJ. A comparative evaluation of working length with digital radiography and third generation apex locator (ProPex) in the presence of various intracanal irrigants: An in vivo/ex vivo study. Dent Res J (Isfahan) 2014; 11:56-60. [PMID: 24688561 PMCID: PMC3955316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Accurate working length determination is a pre-requisite for a successful endodontic treatment. Even with improved systems of working length measurement, different readings may be recorded in different electrolytes present in the canal. The purpose of this in vivo/ex vivo comparative study was to determine the accuracy in measuring the working length of root canal using Direct Digital Radiographic Method (Radiovisiography or RVG) and ProPex electronic apex locator in the presence of three different irrigating solutions: 0.9% normal saline, 2% chlorhexidine, 3% NaOCl solutions. MATERIALS AND METHODS Forty single-rooted human teeth scheduled for extraction with mature apices were selected for this study. Measurements were performed by using RVG and ProPex in the presence of irrigating solutions. After extraction of the teeth, light microscope was used to confirm visually the relationship of the tip of the endodontic file to the apical foramen, and actual lengths were determined by reducing 0.5 mm from this length. The statistical analysis was performed by one-way ANOVA test and Tukey-HSD post hoc procedure. P < 0.05 was considered as significant. RESULTS No significant difference was found between overall mean electronic working length and digital radiographic length; however, prediction error (P < 0.05) was significant with respect to different irrigants. Among the irrigating solutions, chlorhexidine gluconate had the smallest distance to the actual lengths, whereas NaOCl had the greatest. CONCLUSION Electronic apex locator ProPex yielded best result in the presence of chlorhexidine, whereas the largest error was demonstrated with NaOCl indicating that higher electroconductive irrigating solutions affect the precision of multi-frequency apex locators.
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Affiliation(s)
- Irfana Khursheed
- Department of Dentistry, Shere Kashmir Institute of Medical Sciences, Srinagar, India
| | - Ruchika Bansal
- Department of Conservative Dentistry, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India
| | - Tajinder Bansal
- Department of Oral Medicine and Radiology, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India
| | - Harkanwal Preet Singh
- Department of Oral Pathology and Microbiology, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India,Address for correspondence: Dr. Harkanwal Preet Singh, Department of Oral Pathology and Microbiology, Swami Devi Dyal Hospital and Dental College, Panchkula, Haryana, India. E-mail:
| | - Madhulika Yadav
- Department of Pedodontics and Preventive Dentistry, Faculty of Dental Sciences, King George's Medical, University, Lucknow, Uttar Pradesh, India
| | - K. Jetender Reddy
- Department of Oral Medicine and Radiology, Sri Venkata Sai Institute of Dental Sciences, Mahabubnagar, Andhra Pradesh, India
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