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      Accuracy of Root ZXII, E-PEX and FIND apex locators in teeth with vital pulp: an in vivo study

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          Abstract

          Abstract: This research evaluated, in vivo, the accuracy of three electronic apex locators - EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access was performed. The cervical and middle thirds of root canals were instrumented with Reciproc R25, and the K#15 file was used as a standard instrument to determine working length, forming 2 groups: Constriction (insertion of the instrument until the apical constriction limit) and Foramen (insertion of the instrument until the foramen and then repositioning at constriction, without removing the file from the canal). The hand file was stabilized with a light-cured flow resin. After extraction, the samples were analyzed through microCT SkyScan 1272, with CTAN software, which evaluated the proximity between the tip of the file to the apical constriction, providing data for comparative analysis using Kruskal-Wallis and Dunn tests (p<0.05). There was a statistically significant difference in the abilities of the EALs to detect the apical constriction after reaching the foramen with Root ZX II showing higher accuracy (89%). However, there was no difference in the accuracy of the three EALs in detecting the apical constriction without reaching the foramen. Based on the present results, we conclude that EALs may show accurate measures in detecting apical constriction and foramen, even without damaging the periodontal stump in biopulpectomy.

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          Most cited references30

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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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            The position and topography of the apical canal constriction and apical foramen.

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              The fundamental operating principles of electronic root canal length measurement devices.

              It is generally accepted that root canal treatment procedures should be confined within the root canal system. To achieve this objective the canal terminus must be detected accurately during canal preparation and precise control of working length during the process must be maintained. Several techniques have been used for determining the apical canal terminus including electronic methods. However, the fundamental electronic operating principles and classification of the electronic devices used in this method are often unknown and a matter of controversy. The basic assumption with all electronic length measuring devices is that human tissues have certain characteristics that can be modelled by a combination of electrical components. Therefore, by measuring the electrical properties of the model, such as resistance and impedance, it should be possible to detect the canal terminus. The root canal system is surrounded by dentine and cementum that are insulators to electrical current. At the minor apical foramen, however, there is a small hole in which conductive materials within the canal space (tissue, fluid) are electrically connected to the periodontal ligament that is itself a conductor of electric current. Thus, dentine, along with tissue and fluid inside the canal, forms a resistor, the value of which depends on their dimensions, and their inherent resistivity. When an endodontic file penetrates inside the canal and approaches the minor apical foramen, the resistance between the endodontic file and the foramen decreases, because the effective length of the resistive material (dentine, tissue, fluid) decreases. As well as resistive properties, the structure of the tooth root has capacitive characteristics. Therefore, various electronic methods have been developed that use a variety of other principles to detect the canal terminus. Whilst the simplest devices measure resistance, other devices measure impedance using either high frequency, two frequencies, or multiple frequencies. In addition, some systems use low frequency oscillation and/or a voltage gradient method to detect the canal terminus. The aim of this review was to clarify the fundamental operating principles of the different types of electronic systems that claim to measure canal length.
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                Author and article information

                Journal
                bor
                Brazilian Oral Research
                Braz. oral res.
                Sociedade Brasileira de Pesquisa Odontológica - SBPqO (São Paulo, SP, Brazil )
                1806-8324
                1807-3107
                2021
                : 35
                : e080
                Affiliations
                [2] Jacarezinho orgnameUniversidade Estadual do Norte do Paraná orgdiv1School of Dentistry orgdiv2Department of Endodontics Brazil
                [1] Araçatuba São Paulo orgnameUniversidade Estadual Paulista orgdiv1School of Dentistry orgdiv2Department of Endodontics Brazil
                Article
                S1806-83242021000100261 S1806-8324(21)03500000261
                10.1590/1807-3107bor-2021.vol35.0080
                cf28315c-ac46-4357-b8ac-693269aeab2a

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 18 March 2020
                : 11 November 2020
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 0
                Product

                SciELO Brazil

                Categories
                Original Research

                Odontometry,Dental Instruments,Endodontics,Tooth Apex
                Odontometry, Dental Instruments, Endodontics, Tooth Apex

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