Does Root Canal Shaping Effect the Accuracy of Electronic Apex Locators in Curved and Straight Root Canals?

Year 2024, Volume: 14 Issue: 3, 727 - 732, 30.09.2024

Dide Tekinarslan , Damla Erkal , Esen Ercan , Simay Koc , Kürşat Er

https://doi.org/10.33808/clinexphealthsci.1354100

Abstract

Objective: To assess the influence of root canal preparation (RCP) on the precision of electronic apex locators (EALs) in both straight and curved root canals.
Methods: The experimental setup included forty-two extracted human mandibular molars featuring both straight distal canals (0-10 degrees) and curved mesial root canals (30-50 degrees). Initial working length (AWL1) measurements were conducted under a stereomicroscope at X15 magnification prior to root canal preparation (RCP). Subsequently, electronic working length (EWL1) was determined using two different
electronic apex locators (EALs) – Propex-Pixi and EndoRadar. RCP was carried out with ProTaper Ultimate F1, F2 files in mesial canals, and F1, F2, F3 files in distal straight root canals. The RCP procedure involved the implementation of a standard irrigation protocol along with the use of a sonic device for activation. Following RCP, measurements were repeated under a stereomicroscope and documented as AWL2. EWL measurements were also repeated and recorded as EWL2 after the preparation. The variation was calculated by subtracting AWL from EWL for each tooth (EWL1-AWL1 and EWL2-AWL2). Statistical analysis employed Paired Sample t-test and Wilcoxon tests.
Results: There was no statistically significant difference observed in the accuracy of Propex-Pixi and EndoRadar Pro before and after root canal preparation for both straight and curved canals.
Conclusion: Root canal preparation did not alter the accuracy of the electronic apex locators (EALs) used in this study, whether applied to curved or straight root canals.

Keywords

working length, root canal preparation, curvature, straight canal

References

• Rollison S, Barnett F, Stevens RH. Efficacy of bacterial removal from instrumented root canals in vitro related to instrumentation technique and size. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94(3):366-371. DOI: 10.1067/moe.2002.126164
• Kumar R, Khambete N, Patil S, Hoshing U, Medha A, Shetty R. Working length changes in curved canals after coronal flaring by using rotary files and hand file: An in vitro study. J Conserv Dent. 2013;16(5):399-403. DOI: 10.4103/0972-0707.117489
• Guise GM, Goodell GG, Imamura GM. In vitro comparison of three electronic apex locators. J Endod. 2010;36(2):279-281. DOI: 10.1016/j.joen.2009.09.016
• Negishi J, Kawanami M, Ogami E. Risk analysis of failure of root canal treatment for teeth with inaccessible apical constriction. J Dent. 2005;33(5):399-404. DOI: 10.1016/j.jdent.2004.11.003
• Ricucci D, Langeland K. Apical limit of root-canal instrumentation and obturation, part 2. a histological study. Int Endod J. 1998;31(6):394-409. DOI: 10.1046/j.1365-2591.1998.00183.x
• Holland R, Gomes JE, Cintra LTA, Queiroz ÍOdA, Estrela C. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci. 2017;25(5):465-476. DOI: 10.1590/1678-7757-2016-0464
• Thompson SA, Dummer P. M. Shaping ability of Hero 642 rotary nickel-titanium instruments in simulated root canals: Part 1. Int Endod J. 2000;33(3):248-254. DOI: 10.1046/j.1365-2591.2000.00287.x
• Jo J-I, Jin M-U, Kim YK, Kim SK. Change of working length in curved canals by various instrumentation techniques. J Korean Acad Conserv Dent. 2006;31(1):30-35.
• Alodeh M, Doller R, Dummer P. Shaping of simulated root canals in resin blocks using the step‐back technique with K‐files manupulated in a simple in/out filing motion. Int Endod J. 1989;22(3):107-117. DOI: 10.1111/j.1365-2591.1989.tb00908.x
• Briseno B, Sonnabend E. The influence of different root canal instruments on root canal preparation: an in vitro study. Int Endod J. 1991;24(1):15-23. DOI: 10.1111/j.1365-2591.1991.tb00865.x
• Özsezer E, İnan U, Aydın U. In vivo evaluation of ProPex electronic apex locator. J Endod. 2007;33(8):974-977. DOI: 10.1016/j.joen.2007.04.003
• ElAyouti A, Weiger R, Löst C. Frequency of overinstrumentation with an acceptable radiographic working length. J Endod. 2001;27(1):49-52. DOI: 10.1097/00004770-200101000-00018
• ElAyouti A, Weiger R, Löst C. The ability of root ZX apex locator to reduce the frequency of overestimated radiographic working length. J Endod. 2002;28(2):116-119. DOI: 10.1097/00004770-200202000-00017
• Kim E, Marmo M, Lee C-Y, Oh N-S, Kim I-K. An in vivo comparison of working length determination by only root-ZX apex locator versus combining root-ZX apex locator with radiographs using a new impression technique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;105(4):e79-e83. DOI: 10.1016/j.tripleo.2007.12.009
• Altenburger M, Cenik Y, Schirrmeister J, Wrbas KT, Hellwig E. Combination of apex locator and endodontic motor for continuous length control during root canal treatment. Int Endod J. 2009;42(2):368-374. DOI: 10.1111/j.1365-2591.2008.01535.x
• Gordon M, Chandler N. Electronic apex locators. Int Endod J. 2004;37(7):425-437. DOI: 10.1111/j.1365-2591.2004.00835.x
• Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971;32(2):271-275. DOI: 10.1016/0030-4220(71)90230-1
• Schilder H. Cleaning and shaping the root canal. Dent Clin North Am. 1974;18(2):269-296.
• Martins JN, Silva EJNL, Marques D, Ajuz N, Rito Pereira M, Pereira da Costa R, Fernandes FMB, Versiani MA. Characterization of the file‐specific heat‐treated ProTaper Ultimate rotary system. Int Endod J. 2023;56(4):530-542. DOI: 10.1111/iej.13880
• Ruddle CJ. The Ultimate Shaping System: An Opening for 3D Cleaning and Filling Root Canals. https://www.endoruddle.com/tc2pdfs/show/253/ProTaperUltimate_May2022.pdf
• Weine FS, Kelly RF, Lio PJ. The effect of preparation procedures on original canal shape and on apical foramen shape. J Endod. 1975;1(8):255-262. DOI: 10.1016/S0099-2399(75)80037-9
• Stein TJ, Corcoran JF. Radiographic “working length” revisited. Oral Surg Oral Med Oral Pathol. 1992;74(6):796-800. DOI: 10.1016/0030-4220(92)90412-j
• Mentes A, Gencoglu N. Canal length evaluation of curved canals by direct digital or conventional radiography. Oral Surgery Oral Med Oral Pathol Oral Radiol Endod. 2002;93(1):88-91. DOI: 10.1067/moe.2002.119466
• Sadeghi, S. H., and M. Abou Alghasemi. A comparison between the Raypex5 apex locator and conventional radiography for determining working length of straight and curved canals. Iran Endod J. 2007;2(3):101-104. DOI:10.22037/IEJ.V2I3.316
• Santhosh L, Raiththa P, Aswathanarayana S, Panchajanya S, Reddy JT, Susheela SR. Influence of root canal curvature on the accuracy of an electronic apex locator: An in vitro study. J Conserv Dent. 2014;17(6):583-586. DOI: 10.4103/0972-0707.144610
• Kaufman AY, Keila S, Yoshpe M. Accuracy of a new apex locator: An in vitro study. Int Endod J. 2002;35(2):186-192. DOI. 10.1046/j.1365-2591.2002.00468.x
• Goldberg F, Marroquín BB, Frajlich S, Dreyer C. In vitro evaluation of the ability of three apex locators to determine the working length during retreatment. J Endod. 2005;31(9):676-678. DOI: 10.1097/01.don.0000155226.03483.ff
• Ince B, Ercan E, Dalli M, Dulgergil CT, Zorba YO, Colak H. Incidence of postoperative pain after single-and multi-visit endodontic treatment in teeth with vital and non-vital pulp. Eur J Dent. 2009;3(4):273-279.
• Križaj D, Jan J, Valenčič V. Modeling AC current conduction through a human tooth. Bioelectromagnetics. 2004;25(3):185-195. DOI: 10.1002/bem.10189
• Moor RD, Hommez G, Martens L, Boever JD. Accuracy of four electronic apex locators: an in vitro evaluation. Dent Traumatol. 1999;15(2):77-82. DOI: 10.1111/j.1600-9657.1999.tb00758.x
• Venturi M, Breschi L. A comparison between two electronic apex locators: An ex vivo investigation. Int Endod J. 2007;40(5):362-373. DOI: 10.1111/j.1365-2591.2006.01229.x
• Herrera M, Ábalos C, Planas AJ, Llamas R. Influence of apical constriction diameter on Root ZX apex locator precision. J Endod. 2007;33(8):995-998. DOI: 10.1016/j.joen.2007.05.009
• Wu Y, Shi J, Huang L, Xu Y. Variables affecting electronic root canal measurement. Int Endod J. 1992;25(2):88-92. DOI: 10.1111/j.1365-2591.1992.tb00741.x
• Oliveira TN, Vivacqua-Gomes N, Bernardes RA, Vivan RR, Duarte MAH, Vasconcelos BC. Determination of the accuracy of 5 electronic apex locators in the function of different employment protocols. J Endod. 2017;43(10):1663-1667. DOI: 10.1016/j.joen.2017.03.039
• 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(2):158-161. DOI: 10.1016/j.joen.2019.10.035
• Tien M, Tjoa H, Zhou M, Abbott PV. Comparative study of four endodontic file systems to assess changes in working length during root canal instrumentation and the effect of canal curvature on working length change. J Endod. 2020;46(1):110-115.DOI: 10.1016/j.joen.2019.10.004
• Berutti E, Chiandussi G, Paolino DS, Scotti N, Cantatore G, Castellucci A, Pasqualini D. Effect of canal length and curvature on working length alteration with WaveOne reciprocating files. J Endod. 2011;37(12):1687-1690. DOI: 10.1016/j.joen.2011.09.014
• Göçer PA, Durmazpınar PM, Baştürk FB. Performance of two different electronic apex locators during the removal of calcium silicate-based sealers. Int Dent Res. 2023;13(S1): 20-25. DOI: 10.5577/idr.2023.vol13.s1.3
• Koç S, Kuştarcı A, Er K. Accuracy of different electronic apex locators in determination of minimum Root perforation diameter. Aust Endod J. 2023;49:179-186. DOI: 10.1111/aej.12711