Evaluation of The Accuracy of Two Apex Locators For Determining The Working Length of Endodontically Retreated Curved Mesial Roots of Maxillary Molar Teeth : An Ex Vivo Study

Year 2024, Volume: 34 Issue: 4, 253 - 257, 15.10.2024

Dilara Arslan Mira Kebudi Benezra Fatma Kaplan Mehmet Burak Güneşer

https://doi.org/10.17567/currresdentsci.1555982

Abstract

Objective: To evaluate the accuracy of PROPEX PİXİ (Dentsply Sirona, Ballaigues, Switzerland) and Apex ID (Sybron Endo, Orange, CA, USA) in determining the working lengths of curved mesial roots of upper molars during the retreatment procedure.
Method: Twenty curved mesial roots of upper molar teeth were selected. Canals were shaped with ProTaper Next instruments (Dentsply Sirona) up to X3. The canal lengths were determined with a microscope (Carl Zeiss GmbH, Oberkochen, Germany) at 2,5X magnification (DM) and then also detected electronically (EM1P and EM1A) with PROPEX PİXİ (Dentsply Sirona) and Apex ID (Sybron Endo) in an alginate model. Specimens were then obturated using a size X3 master gutta-percha cone and an epoxy resin-based root canal sealer. Seven days later, the coronal part of the filling was removed with a Gates Glidden drill size 3 and for the middle part Protaper Universal Retreatment File D2 used. Working lengths electronically were detected again by two different apex locaters (EM2P and EM2A). Data were analysed by using the Wilcoxon Signed Rank and Mann Whitney u test. The analyses were carried out with MedCalc Statistical Software.
Results: No significant difference was found between direct measurements (DM) and electronic measurements before and during retreatment for PROPEX PİXİ (P=0.135) and Apex ID (P=0.232). Also there was no significant difference between two apex locaters before (P=0.108) and during retreatment (P=0.242)
Conclusion: PROPEX PİXİ and Apex ID were considered accurate for the root canal length determination during retreatment procedure.
Keywords: Apex locator, curved molar, retreatment, working lenght

Keywords

Apex locator, curved molar, retreatment, working lenght

References

• 1. Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis.Int Endod J. 1997;30(5):297-306. doi:10.1046/j.1365-2591.1997.00092.x
• 2. Kuttler Y. Microscopic investigation of root apexes. J Am Dental Assoc. 1955;50(5):544-552. doi:10.14219/JADA.ARCHIVE.1955.0099
• 3. Üstün Y, Aslan T, Şekerci AE, Sağsen B. Evaluation of the Reliability of Cone-beam Computed Tomography Scanning and Electronic Apex Locator Measurements in Working Length Determination of Teeth with Large Periapical Lesions. J Endod. 2016;42(9):1334-1337. doi:10.1016/j.joen.2016.06.010
• 4. Martínez‐Lozano MA, Forner‐Navarro L, Sánchez‐Cortés JL, Llena‐Puy C. Methodological considerations in the determination of working length. Int Endod J. 2001;34(5):371-376. doi:10.1046/j.1365-2591.2001.00400.x
• 5. Tamse A, Kaffe I, Fishel D. Zygomatic arch interference with correct radiographic diagnosis in maxillary molar endodontics. Oral Surg Oral Med Oral Pathol. 1980;50(6):563-565. doi:10.1016/0030-4220(80)90441-7
• 6. Al‐bulushi A, Levinkind M, Flanagan M, Ng Y ‐l., Gulabivala K. Effect of canal preparation and residual root filling material on root impedance.Int Endod J. 2008;41(10):892-904. doi:10.1111/j.1365-2591.2008.01450.x
• 7. Aggarwal V, Singla M, Kabi D. An In Vitro Evaluation of Performance of Two Electronic Root Canal Length Measurement Devices during Retreatment of Different Obturating Materials. J Endod. 2010;36(9):1526-1530.doi:10.1016/j.joen.2010.04.016
• 8. Er O, Uzun O, Ustun Y, Canakcı BC, Yalpı F. Effect of solvents on the accuracy of the Mini Root ZX apex locator. Int Endod J. 2013;46(11):1088-1095. doi:10.1111/iej.12111
• 9. Ebrahim AK, Wadachi R, Suda H. In vitro evaluation of the accuracy of five different electronic apex locators for determining the working length of endodontically retreated teeth. Aust Endod J. 2007;33(1):7-12. doi:10.1111/j.1747-4477.2007.00049.x
• 10. 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
• 11. Mancini M, Palopoli P, Iorio L, Conte G, Cianconi L. Accuracy of an Electronic Apex Locator in the Retreatment of Teeth Obturated with Plastic or Cross-linked Gutta-percha Carrier-based Materials: An Ex Vivo Study. J Endod. 2014;40(12):2061-2065. doi:10.1016/j.joen.2014.07.035
• 12. De Vasconcelos BC, Chaves RDV, Vivacqua-Gomes N, et al. Ex Vivo Evaluation of the Accuracy of Electronic Foramen Locators in Root Canals with an Obstructed Apical Foramen. J Endod. 2015;41(9):1551-1554. doi:10.1016/j.joen.2015.06.009
• 13. Nekoofar MH, Ghandi MM, Hayes SJ, Dummer PM. The fundamental operating principles of electronic root canal length measurement devices. Int Endod J. 2006;39(8):595-609. doi: 10.1111/j.1365-2591.2006.01131.x.
• 14. Piasecki L, Reis PJD, Jussiani EI, Andrello AC. A Micro–computed Tomographic Evaluation of the Accuracy of 3 Electronic Apex Locators in Curved Canals of Mandibular Molars. J Endod.2018;44(12):1872-1877 doi:10.1016/j.joen.2018.09.001
• 15. Vasconcelos BC, Bastos LM, Oliveira AS, Bernardes RA, Duarte MA, Vivacqua-Gomes N, Vivan RR. Changes in Root Canal Length Determined during Mechanical Preparation Stages and Their Relationship with the Accuracy of Root ZX II. J Endod. 2016 Nov;42(11):1683-1686.
• 16. Krajczár K, Marada G, Gyulai G, Tóth V. Comparison of radiographic and electronical working length determination on palatal and mesio-buccal root canals of extracted upper molars. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(2):e90-e93. doi:10.1016/j.tripleo.2008.04.007
• 17. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surgery Oral Medicine Oral Pathology. 1971;32(2):271-275. doi:10.1016/0030-4220(71)90230-1
• 18. 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
• 19. Cimilli H, Aydemir S, Arıcan B, Mumcu G, Chandler N, Kartal N. Accuracy of the Dentaport ZX apex locator for working length determination when retreating molar root canals. Aust Endod J. 2012;40(1):2-5. doi:10.1111/aej.12010
• 20. Alves AMH, Felippe MCS, Felippe WT, Rocha MJC. Ex vivo evaluation of the capacity of the Tri Auto ZX to locate the apical foramen during root canal retreatment.Int Endod J. 2005;38(10):718-724. doi:10.1111/j.1365-2591.2005.01007.x
• 21. D́Assunção FLC, De Albuquerque DS, De Queiroz Ferreira LC. The Ability of Two Apex Locators to Locate the Apical Foramen: An In Vitro Study. J Endod. 2006;32(6):560-562. doi:10.1016/j.joen.2005.11.011
• 22. Baldi JV, Victorino FR, Bernardes RA, et al. Influence of Embedding Media on the Assessment of Electronic Apex Locators. J Endod. 2007;33(4):476-479. doi:10.1016/j.joen.2006.12.024
• 23. Yolagiden M, Ersahan S, Suyun G, Bilgec E, Aydin C. Comparison of Four Electronic Apex Locators in Detecting Working Length: An Ex Vivo Study. The Journal of Contemporary Dental Practice. 2018;19(12):1427-1433. doi:10.5005/jp-journals-10024-2444
• 24. 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
• 25. Saxena D, Saha S, Bharadwaj A, Vijaywargiya N, Dubey S, Kala S. A comparative evaluation of accuracy of three electronic apex locators using histological section as gold standard: An ex vivo study. J Conservativ Dent. 2017;20(4):251. doi:10.4103/jcd.jcd_175_16 26. Tufenkci P, Kalaycı A. Evaluation of the accuracy of different apex locators in determiningthe working length during root canal retreatment. J Dent Res Dent Clin Dent Pros. 2020;14(2):125-129. doi:10.34172/joddd.2020.026
• 27. Tejaswi S, Viresh GA, Singh A, Shetty S, Ambikathanaya UK, Manglekar SB. To Evaluate the Accuracy Between Two Different Electronic Apex Locators to Detect the Root Canal Perforation During Retreatment - An Ex-Vivo Study. Indian J Sci Technol. 2022;15(42):2259-2266. doi:10.17485/ijst/v15i42.1582