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      Comparative evaluation of the accuracy of two electronic apex locators in determining the working length in teeth with simulated apical root resorption: An in vitro study

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          Accurate determination of working length (WL) is a critical factor for endodontic success. This is commonly achieved using an apex locator which is influenced by the presence or absence of the apical constriction. Hence, this study was done to compare the accuracy of two generations of apex locators in teeth with simulated apical root resorption.

          Materials and Methods:

          Forty maxillary central incisors were selected and after access preparation, were embedded in an alginate mold. On achieving partial set, teeth were removed, and a 45° oblique cut was made at the apex. The teeth were replanted and stabilized in the mold, and WL was determined using two generations of apex locators (Raypex 5 and Apex NRG XFR). Actual length of teeth (control) was determined by visual method.

          Statistical Analysis:

          Results were subjected to statistical analysis using the paired t-test.


          Raypex 5 and Apex NRG was accurate for only 33.75% and 23.75% of samples, respectively. However, with ±0.5 mm acceptance limit, they showed an average accuracy of 56.2% and 57.5%, respectively. There was no significant difference in the accuracy between the two apex locators.


          Neither of the two apex locators were 100% accurate in determining the WL.

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          Most cited references 27

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          Factors affecting the long-term results of endodontic treatment.

          The influence of various factors that may affect the outcome of root canal therapy was evaluated in 356 patients 8 to 10 yr after the treatment. The results of treatment were directly dependent on the preoperative status of the pulp and periapical tissues. The rate of success for cases with vital or nonvital pulps but having no periapical radiolucency exceeded 96%, whereas only 86% of the cases with pulp necrosis and periapical radiolucency showed apical healing. The possibility of instrumenting the root canal to its full length and the level of root filling significantly affected the outcome of treatment. Of all of the periapical lesions present on previously root-filled teeth, only 62% healed after retreatment. The predictability from clinical and radiographic signs of the treatment-outcome in individual cases with preoperative periapical lesions cases was found to be low. Thus, factors which were not measured or identified may be critical to the outcome of endodontic treatment.
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            Apical limit of root canal instrumentation and obturation, part 2. A histological study.

            The results of an in vivo histological study involving apical and periapical tissues following root canal therapy after different observation periods demonstrated the most favourable histological conditions when the instrumentation and obturation remained at or short of the apical constriction. This was the case in the presence of vital or necrotic pulps, also when bacteria had penetrated the foramen and were present in the periapical tissues. When the sealer and/or the gutta-percha was extruded into the periapical tissue, the lateral canals and the apical ramifications, there was always a severe inflammatory reaction including a foreign body reaction despite a clinical absence of pain.
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              Electronic apex locators.

              Prior to root canal treatment at least one undistorted radiograph is required to assess canal morphology. The apical extent of instrumentation and the final root filling have a role in treatment success, and are primarily determined radiographically. Electronic apex locators reduce the number of radiographs required and assist where radiographic methods create difficulty. They may also indicate cases where the apical foramen is some distance from the radiographic apex. Other roles include the detection of root canal perforation. A review of the literature focussed first on the subject of electronic apex location. A second review used the names of apex location devices. From the combined searches, 113 pertinent articles in English were found. This paper reviews the development, action, use and types of electronic apex locators.

                Author and article information

                J Conserv Dent
                J Conserv Dent
                Journal of Conservative Dentistry : JCD
                Medknow Publications & Media Pvt Ltd (India )
                Sep-Oct 2016
                : 19
                : 5
                : 402-405
                Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Manipal, Karnataka, India
                Author notes
                Address for correspondence: Dr. Archit Kedia, Department of Conservative Dentistry and Endodontics, Manipal College of Dental Sciences, Manipal University, Manipal - 576 104, Karnataka, India. E-mail: dr.architkedia@ 123456gmail.com
                Copyright: © Journal of Conservative Dentistry

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                Original Research Article


                apex locator, apical resorption, working length


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