Accuracy of Four Electronic Apex Locators During Root Canal Length Determination

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Abstract

ABSTRACT: The apical limit of tooth roots for instrumentation and obturation is a controversial subject due to the high morphological complexity presented by the apical zone of the root. The development of electronic apex locators (EALs) has made working length (WL) determination more predictable, producing more accurate results; however, the interpretation mechanisms of different devices may affect measurements taken under different clinical conditions. One hundred premolars were used to compare the effectiveness of Propex II, Raypex 6, Propex Pixi and Root ZX II in locating the apical foramen (AF). No statistically significant differences were observed when the accuracy of measurement was compared between the different groups of EALs, however Root ZX II and Raypex 6 presented the best overall performance.

Translated abstract

RESUMEN: El límite apical radicular para la instrumentación y obturación es un tema controversial, debido a la alta complejidad morfológica que presenta la zona apical de la raíz. El desarrollo de localizadores de ápice electrónicos (EALs) ha hecho la determinación de la longitud de trabajo (WL) más predecible y con resultados más precisos. Sin embargo, el mecanismo de interpretación de cada dispositivo puede afectar la determinación de las mediciones en diferentes condiciones clínicas. Cien premolares fueron utilizados para comparar la efectividad de Propex II, Raypex 6, Propex Pixi y Root ZX II en localizar el foramen apical (AF). No se observaron diferencias estadísticamente significativas cuando se comparó la precisión de medición entre los diferentes grupos de EALs, sin embargo, Root ZX II y Raypex 6 mostraron un mejor desempeño global.

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Most cited references 25

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In vivo comparison of working length determination with two electronic apex locators.

Jörg F Schirrmeister, ERIN M. ALTENBURGER, K T Wrbas … (2007)

To compare the accuracy of two electronic apex locators (EALs) in the same teeth in vivo. The working lengths in 20 teeth with a single canal were determined with two different EALs (Root ZX; J. Morita Corporation, Tokyo, Japan and Raypex 5 VDW, Munich, Germany) before extraction. When the first EAL was used the files were advanced until the display indicated the 'apical constriction'. The files were then fixed in removable and replaceable light curing composite patterns. The procedure was repeated in the same tooth with the second EAL and a different file. The teeth were then extracted and the apical 4 mm of the root canals were exposed. After that the apical parts with the repositioned files in the canals were digitally photographed under a light microscope. On the images the minor diameter and the major foramen of each sample were marked and the respective distances of the file tips from these positions were measured with a computer program. Subsequently the values of the two groups of EALs were compared using a paired sample t-test. The minor foramen was located within the limits of +/-0.5 mm in 75% of the cases with the Root ZX and in 80% of the cases with Raypex 5. The paired sample t-test showed no significant difference between the EALs regarding determination of the minor foramen. The use of EALs is a reliable method for determining working length. The differences between the two EALs were not statistically significant.

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In vivo accuracy of three electronic root canal length measurement devices: Dentaport ZX, Raypex 5 and ProPex II.

F Somma, L Marigo, R Castagnola … (2012)

To compare in vivo three different electronic root canal length measurement devices: Dentaport ZX, Raypex 5 and ProPex II. Thirty single-rooted permanent teeth scheduled for extraction because of periodontal disease were selected from 10 adult patients (ranging from 45 to 67 years) and divided into three groups of 10 teeth. Before the extraction, an access cavity was prepared and the crown was adjusted to establish a stable reference point for all measurements. The working length in Group 1 was determined using the Dentaport ZX apex locator. A K-file with the largest diameter that could reach the last green bar on the screen was stabilized in the canal using a dual-curable flow resin composite. The same procedure was used for the Raypex 5 (the file reached the last yellow bar) and Propex II (0.0 orange bar) apex locators. The teeth were then extracted and cleared. The distance between the tip of the file and the major foramen was then calculated for each tooth using digital photography according to Axiovision AC software (Carl Zeiss). Positive values were assigned when the file tip passed beyond the major foramen, negative values when the tip was short of the foramen and zero value when the file tip and the foramen coincided. Statistical analysis was performed using the chi-squared test or Fisher's exact test (P ≤ 0.05). Dentaport ZX, Raypex 5 and ProPex ΙΙ produced, respectively, 6, 2 and 4 out of 10 correct measurements, 0, 6 and 5 long measurements and 4, 2, and 1 short measurements. The differences between the three electronic root canal length measurement devices were not significant (P = 0.507). Under the in vivo conditions of this study, the three electronic root canal length measurement devices were not significantly different in terms of locating the major foramen. © 2012 International Endodontic Journal.

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In vitro comparison of three electronic apex locators.

Gary G Goodell, Marta Imamura, Kevin G. Guise (2010)

The purpose of this study was to compare the accuracy of the Root ZX II Apex Locator (RZX), the Elements Apex Locator (ELE), and the Precision Apex Locator (PAL). Forty single-rooted extracted teeth were decoronated and the root canals coronally flared. Actual canal lengths were determined by inserting a #10 file until the tip was visualized (12.8x magnification) just within the apical foramina. Teeth were mounted in gelatin conducting medium and randomly tested with each electronic apex locator (EAL) to determine the electronic canal length. Differences between the electronic and actual canal lengths were calculated. The mean differences were -0.02 mm, 0.13 mm, and 0.15 mm for the RZX, PAL, and ELE, respectively. One-way analysis of variance showed a highly significant difference among EALs (p = 0.003). Student-Newman-Keuls post hoc analysis found significant differences between the RZX and the PAL and between the RZX and the ELE at p < 0.05. No significant difference was noted between the PAL and the ELE. The proportion of electronic canal length measurements falling within +/-0.5 mm of the actual canal lengths for the EALs was as follows: 97.5% for the RZX, 95% for the PAL, and 90% for the ELE. The RZX was the most accurate at locating the apical foramen compared with the ELE and the PAL. Published by Elsevier Inc.