Genişletilmiş apikal foramenlere sahip dişlerde multi-frekans elektronik apeks bulucuların doğruluğunun karşılaştırılması: ex vivo

Yıl 2018, Cilt: 35 Sayı: 1, 17 - 22, 24.09.2017

Mügem Aslı Ekici Bağdagül Helvacıoğlu Kıvanç , Adil Ekici

https://doi.org/10.17214/gaziaot.315396

Öz

Amaç: Bu çalışmanın amacı, farklı
çaplarda apikal foramenlere sahip dişlerde yeni geliştirilmiş multi-frekans elektronik
apeks bulucu iPex II ile üç farklı multi-frekans elektronik apeks bulucunun
doğruluğunun karşılaştırılmasıdır.

Gereç ve Yöntem: Çalışmada 26 adet çekilmiş
alt çene küçük azı dişi kullanıldı. Dişlerin kronlarının uzaklaştırılmasından
sonra kök kanalları koronal olarak genişletildi. Gerçek çalışma boyu tespiti,
#15 K-tipi eğenin ucu apikal foramende görünür hale gelene kadar ilerletilerek
yapıldı. Gerçek çalışma boyu, lastik stoper ve eğe arasındaki uzunluktan 0.5 mm kısa olarak kabul
edildi. ProTaper F1, F2 ve F3 (Dentsply Maillefer) eğeler ile apikal açıklıktan 1
mm ilerde taşkın preparasyonlar yapıldı. Dişler,
koronal 5 mm’leri açıkta kalacak şekilde aljinat ile teflon kalıplara gömüldü.
Raypex 5 (VDW), Raypex 6 (VDW), iPex (NSK Inc.) ve iPex II (NSK Inc.)
elektronik apeks bulucular kullanılarak elektronik çalışma boyu ölçümleri
yapıldı. Elektronik ve gerçek çalışma boyları arasındaki farklar hesaplandı.
Elektronik apeks bulucuların doğruluklarının istatistiksel değerlendirmesinde
tek yönlü varyans analizi (ANOVA) kullanıldı (α=0.05).

Bulgular: Gruplar-arası
karşılaştırmada, elektronik apeks bulucuların doğrulukları arasında
istatistiksel olarak anlamlı farklılık görülmedi (p>0.05). Grup-içi
karşılaştırmada, farklı apikal foramen çaplarına göre elektronik apeks
bulucuların doğrulukları arasında yine istatistiksel olarak anlamlı farklılık
görülmedi (p>0.05).

Sonuç: Apikal
foramenleri genişletilmiş dişlerde, iPex II ve diğer elektronik apeks
bulucuların çalışma boyu ölçümleri arasında farklılık olmadığı görüldü. Kullanılan
tüm elektronik apeks bulucuların çalışma boyu ölçümlerinin klinik olarak kabul
edilebilir olduğu bulundu.

Anahtar Kelimeler

Apikal foramen, dişler, kök kanal tedavisi

Comparison of the accuracies of multi-frequency electronic apex locators in teeth with enlarged apical foramina: ex vivo

Öz

Objective: The aim of this study was to compare the accuracy
of a newly developed multi-frequency electronic apex locator iPex II with three
different multi-frequency electronic apex locators in teeth with different
sizes of apical foramina.

Materials and Method: Twenty-six extracted mandibular
premolars were used in this study. The teeth were decoronated, and the root
canals were coronally flared. Actual working length was determined by inserting
a #15 K-file until the tip was visualized just within apical foramen. Actual
working length was established 0.5
mm short of the distance between the rubber stopper and
the file tip. Using Protaper F1, F2 and F3 files (Dentsply Maillefer),
over-instrumentation 1 mm
beyond the apical foramen was done. The teeth were embedded in teflon molds
with alginate exposing the coronal 5
mm. Electronic working length measurements were done by
using Raypex 5 (VDW), Raypex 6 (VDW), iPex (NSK Inc.) and iPex II (NSK Inc.)
electronic apex locators. Differences between the electronic and actual working
lengths were calculated. One-way analysis of variance (ANOVA) was used for the
statistical analysis of the accuracies of the electronic apex locators (α=0.05).

Results: Inter-group comparisons revealed that
there was no statistically significant difference between the accuracies of the
different electronic apex locators (p>0.05). Intra-group comparisons also
revealed that there was no statistically significant difference between
different apical foramen sizes (p>0.05).

Conclusion: iPex II and the other electronic apex locators
provided similar endodontic working length measurements in teeth with enlarged
apical foramina. All electronic apex locators tested in this study were found
clinically acceptable for working length determination.

Anahtar Kelimeler

Apical foramen, root canal therapy, teeth

Kaynakça

• Inoue N, Skinner DH. A simple and accurate way to measuring root canal length. J Endod 1985;11:421-7.
• American Assoication of Endodontists. Glossary of Endodontic Terms. Available at: http://www.nxtbook.com/nxtbooks/aae/endodonticglossary/index.php. Accessed April 9, 2015.
• Chugal NM, Clive JM, Spangberg LS. Endodontic infection: some biologic and treatment factors associated with outcome. Oral Sug Oral Med Oral Pathol Oral Radiol Endod 2003;96:81-90.
• Real DG, Davidowicz H, Moura-Netto C, Zenkner Cde L, Pagliarin CM, Barletta FB, et al. Accuracy of working length determination using 3 electronic apex locators and direct digital radiography. Oral Sug Oral Med Oral Pathol Oral Radiol Endod 2011;111:e44-9.
• Koçak S, Koçak MM, Sağlam BC. Efficiency of 2 electronic apex locators on working length determination: A clinical study. J Conserv Dent 2013;16:229-32.
• Chakravarthy Pishipati KV. An in vitro comparison of Propex II apex locator to standard radiographic method. Iran Endod J 2013;8:114-7.
• Pratten DH, McDonald NJ. Comparison of radiographic and electronic working lengths. J Endod 1996;22:173-6.
• 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;28:116-9.
• Ebrahim AK, Wadachi R, Suda H. An in vitro evaluation of the accuracy of Dentaport ZX apex locator in enlarged root canals. Aust Dent J 2007;52:193-7.
• Herrera M, Abalos C, Lucena C, Jiménez-Planas A, Llamas R. Critical diameter of apical foramen and of file size using the Root ZX apex locator: an in vitro study. J Endod 2011;37:1306-9.
• Akisue E, Gratieri SD, Barletta FB, Caldeira CL, Grazziotin-Soares R, Gavini G. Not all electronic foramen locators are accurate in teeth with enlarged apical foramina: an in vitro comparison of 5 brands. J Endod 2014;40:109-12.
• Gordon MP, Chandler NP. Electronic apex locators. Int Endod J 2004;37:425-37.
• Lee M, Winkler J, Hartwell G, Stewart J, Caine R. Current trends in endodontic practice: emergency treatments and technological armamentarium. J Endod 2009;35:35-9.
• Fouad AF, Krell KV, McKendry DJ, Koorbusch GF, Olson RA. Clinical evaluation of five electronic root canal length measurements. J Endod 1990;16:446-9.
• Duran-Sindreu F, Stöber E, Mercadé M, Vera J, Garcia M, Bueno R, et al. Comparison of in vivo and in vitro readings when testing the accuracy of the Root ZX apex locator. J Endod 2012;38:236-9.
• Wrbas KT, Ziegler AA, Altenburger MJ, Schirmeister JF. In vivo comparison of working length determination with two electronic apex locators. Int Endod J 2007;40:133-8.
• McDonald NJ. The electronic determination of working length. Dent Clin North Am 1992;36:293-307.
• Ebrahim AK, Wadachi R, Suda H. Ex vivo evaluation of the ability of four different apex locators to determine the working length in teeth with various foramen diameters. Aust Dent J 2006;51:258-62.
• Renner D, Grazziotin-Soares R, Gavini G, Barietta FB. Influence of pulp condition on the accuracy of an electronic foramen locator in posterior teeth: an in vivo study. Braz Oral Res 2012;26:106-11.
• Gehlot PM, Manjunath V, Manjunath MK. An in vitro evaluation of the accuracy of four electronic apex locators using stainless-steel and nickel-titanium hand files. Restor Dent Endod 2016;41:6-11.
• ElAyouti A, Kimionis I, Chu AL, Löst C. Determining the apical terminus of root-end resected teeth using three modern apex locators: a comparative ex vivo study. Int Endod J 2005;38:827-33.
• Gutmann JL, Leonard JE. Problem solving in endodontic working-length determination. Compend Contin Educ Dent 1995;16:288-94.
• Ounsi HF, Naaman A. In vitro evaluation of the reliability of the Root ZX electronic apex locator. Int Endod J 1999;32:120-3.
• Aydın U, Karataslioglu E, Aksoy F, Yildirim C. In vitro evaluation of Root ZX and Raypex 6 in teeth with different apical diameters. J Conserv Dent 2015;18:66-9.
• Fouad AF, Rivera EM, Krell KV. Accuracy of the Endex with variations in canal irrigants and foramen size. J Endod 1993;19:63-7.
• Welk AR, Baumgartner JC, Marshall JG. An in vivo comparison of two frequency-based electronic apex locators. J Endod 2003;29:497-500.
• Plotino G, Grande NM, Brigante L, Lesti B, Somma F. Ex vivo accuracy of three electronic apex locators: Root ZX, Elements Diagnostic Unit and Apex Locator and Propex. Int Endod 2006;39:408-14.
• Martins JN, Marques D, Mata A, Caramês J. Clinical efficacy of electronic apex locators: systematic review. J Endod 2014;40:759-77.
• Swapna DV, Krishna A, Patil AC, Rashmi K, Pai VS, Ranjini MA. Comparison of third generation versus fourth generation electronic apex locators in detecting apical constriction: An in vivo study. J Conserv Dent 2015;18:288-91.
• Somma F, Castagnola R, Lajolo C, Paternò Holtzman L, Marigo L. In vivo accuracy of three electronic root canal length measurement devices: Dentaport ZX, Raypex 5 and ProPex II. Int Endod J 2012;45:552-6.
• Moscoso S, Pineda K, Basilio J, Alvarado C, Roig M, Duran-Sindreu F. Evaluation of Dentaport ZX and Raypex 6 electronic apex locators: an in vitro study. Med Oral Patol Oral Cir Bucal 2014;19:e202-5.
• Duran-Sindreu F, Gomes S, Stöber E, Mercadé M, Jané L, Roig M. In vivo evaluation of the iPex and Root ZX electronic apex locators using various irrigants. Int Endod J 2013;46:769-74.
• Aggarwal V, Singla M, Bhasin SS. Influence of instrument size and varying electrical resistance of root canal instruments on accuracy of three electronic root canal lenght measurement devices. Int Endod J 2017;50:506-11.