Keywords :
Cone-beam computed tomography, Electronic apex locator, Working length
Citation Information :
Agarwal S, Raghu R, Shetty A, Gautham P, Rajasekhara S, Yadav P. In Vitro Comparative Evaluation of the Accuracy of Three Electronic Apex Locators in Mandibular Molars Using Cone-beam Computed Tomography. J Oper Dent Endod 2021; 6 (2):65-68.
Background: Accurate estimation of the working length (WL) from the coronal reference point to the minor diameter (apical constriction) is critical in endodontic therapy. Many electronic apex locators are available to precisely measure this apical limit.
Aim: To assess the precision of three current electronic apex locators—Root ZX Mini, CanalPro, and Apex ID in the mesial canals of mandibular molars. Cone-beam computed tomography (CBCT) was employed to verify their accuracy.
Materials and methods: Thirty mandibular first molars with curved mesial roots were selected. Cone-beam computed tomography (CBCT) was used to assess the length of the teeth. Samples were decoronated and mesiobuccal canal orifices were enlarged with Hyflex CM 25/08 and irrigated with 2 mL 3% sodium hypochlorite. Canals were prepared with size 10 K-file and the measurements were recorded with apex locators at marks “APEX 0/0” and “0.5 mark” as electronic tooth length and the electronic WL, respectively by visual means, and this was verified using CBCT. Statistical analysis was done using the repeated measures of ANOVA test.
Results: CanalPro, Root ZX Mini, and CBCT values were very similar. Apex ID values were longer than CBCT values.
Conclusion: CanalPro readings closely matched those of CBCT measurement followed by Root ZX mini. Apex ID showed longer readings.
Yılmaz F, Kamburoglu K, Senel B. Endodontic working length measurement using cone-beam computed tomographic images obtained at different voxel sizes and field of views, periapical radiography, and apex locator: a comparative ex vivo study. J Endod 2017;43(1):152–156. DOI: 10.1016/j.joen.2016.09.019.
Segato AVK, Piasecki L, Felipe Iparraguirre Nunovero M, et al. The accuracy of a new cone-beam computed tomographic software in the preoperative working length determination ex vivo. J Endod 2018;44(6):1024–1029. DOI: 10.1016/j.joen.2018.02.027.
Piasecki L, Carneiro E, da Silva Neto UX, et al. The use of micro–computed tomography to determine the accuracy of 2 electronic apex locators and anatomic variations affecting their precision. J Endod 2016;42(8):1263–1267. DOI: 10.1016/j.joen.2016.04.024.
Kuttler Y. Microscopic investigation of root apexes. J Am Dent Assoc 1955;50(5):544–552. DOI: 10.14219/jada.archive.1955.0099.
Aggarwal G, Bogra P, Gupta S, et al. Determination of apical constriction and apical foramen using electronic apex locator in vivo: comparison between vital and nonvital teeth. Saudi Endod J 2018;8(2):99–105. DOI: 10.4103/sej.sej_35_17.
Nekoofar MH, Ghandi MM, Hayes SJ, et al. 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.
Jeger FB, Janner SF, Bornstein MM, et al. Endodontic working length measurement with preexisting cone-beam computed tomography scanning: a prospective, controlled clinical study. J Endod 2012;38(7):884–888. DOI: 10.1016/j.joen.2012.03.024.
Janner SF, Jeger FB, Lussi A, et al. Precision of endodontic working length measurements: a pilot investigation comparing cone-beam computed tomography scanning with standard measurement techniques. J Endod 2011;37(8):1046–1051. DOI: 10.1016/j.joen.2011.05.005.
de Morais AL, de Alencar AH, Estrela CR, et al. Working length determination using cone-beam computed tomography, periapical radiography and electronic apex locator in teeth with apical periodontitis: a clinical study. Iran Endod J 2016;11(3):164–168. DOI: 10.7508/iej.2016.03.003.
Martins JN, Marques D, Mata A, et al. Clinical efficacy of electronic apex locators: systematic review. J Endod 2014;40(6):759–777. DOI: 10.1016/j.joen.2014.03.011.
Eslinger B. Accuracy of cone beam computed tomography (CBCT) in determining root canal working length. Thesis submitted as partial fulfillment for the degree of Master of Science in Oral Sciences in the Graduate College of the University of Illinois at Chicago; 2012.
Lucena C, Lopez JM, Martin JA, et al. Accuracy of working length measurements: electronic apex locator versus cone-beam computed tomography. Int Endod J 2014;47(3):246–256. DOI: 10.1111/iej.12140.
Connert T, Hulber JM, Godt A, et al. Accuracy of endodontic working length determination using cone beam computed txomography. Int Endod J 2014;47(7):698–703. DOI: 10.1111/iej.12206.
Piasecki L, Jose Dos Reis P, Jussiani EI, et al. 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.
Ghule KD, Naik S. Comparing the accuracy of cone beam computed tomography and electronic apex locator for root canal length determination in primary teeth. J Indian Soc Pedod Prev Dent 2019;37(2):157–161. DOI: 10.4103/1319-2442.261334.
Taneja S, Kumar M, Sharma SS, et al. Comparative evaluation of accuracy of three electronic apex locators in different simulated clinical conditions–an in vitro study. Ann Med Health Sci Res 2017;7:190–194.
Lekshmy DS, Deepthi PR, Ganesh C, et al. A comparative clinical study on the correlation of working length determined using three different electronic apex locators with radiographic working length: an in vivo study. Endodontology 2016;28(1):18–22. DOI: 10.4103/0970-7212.184325.
