Restor Dent Endod.  2017 Aug;42(3):200-205. 10.5395/rde.2017.42.3.200.

In vivo assessment of accuracy of Propex II, Root ZX II, and radiographic measurements for location of the major foramen

• Tampelini
• Coelho MS
• Rios MD
• Fontana CE
• Rocha DG
• Pinheiro S
• Bueno CE

• KMID: 2386773
• DOI: http://doi.org/10.5395/rde.2017.42.3.200

Abstract

OBJECTIVES
The aim of this in vivo study was to assess the accuracy of 2 third-generation electronic apex locators (EALs), Propex II (Dentsply Maillefer) and Root ZX II (J. Morita), and radiographic technique for locating the major foramen (MF).
MATERIALS AND METHODS
Thirty-two premolars with single canals that required extraction were included. Following anesthesia, access, and initial canal preparation with size 10 and 15 K-flex files and SX and S1 rotary ProTaper files, the canals were irrigated with 2.5% sodium hypochlorite. The length of the root canal was verified 3 times for each tooth using the 2 apex locators and once using the radiographic technique. Teeth were extracted and the actual WL was determined using size 15 K-files under a × 25 magnification. The Biostat 4.0 program (AnalystSoft Inc.) was used for comparing the direct measurements with those obtained using radiographic technique and the apex locators. Pearson's correlation analysis and analysis of variance (ANOVA) were used for statistical analyses.
RESULTS
The measurements obtained using the visual method exhibited the strongest correlation with Root ZX II (r = 0.94), followed by Propex II (r = 0.90) and Ingle's technique (r = 0.81; p < 0.001). Descriptive statistics using ANOVA (Tukey's post hoc test) revealed significant differences between the radiographic measurements and both EALs measurements (p < 0.05).
CONCLUSIONS
Both EALs presented similar accuracy that was higher than that of the radiographic measurements obtained with Ingle's technique. Our results suggest that the use of these EALs for MF location is more accurate than the use of radiographic measurements.

Keyword

Dental pulp cavity; Electronic apex locators; Endodontic; Radiographs; Therapeutics; Working length

MeSH Terms

Anesthesia
Bicuspid
Dental Pulp Cavity
Methods
Sodium Hypochlorite
Tooth
Sodium Hypochlorite

Reference

1. Tsesis I, Blazer T, Ben-Izhack G, Taschieri S, Del Fabbro M, Corbella S, Rosen E. The precision of electronic apex locators in working length determination: a systematic review and meta-analysis of the literature. J Endod. 2015; 41:1818–1823.

2. Ricucci D. Apical limit of root canal instrumentation and obturation, part 1. literature review. Int Endod J. 1998; 31:384–393.

3. Siqueira JF Jr, Rôças IN, Favieri A, Machado AG, Gahyva SM, Oliveira JC, Abad EC. Incidence of postoperative pain after intracanal procedures based on an antimicrobial strategy. J Endod. 2002; 28:457–460.

4. Kuttler Y. Microscopic investigation of root apexes. J Am Dent Assoc. 1955; 50:544–552.

5. Ponce EH, Vilar Fernández JA. The cemento-dentino-canal junction, the apical foramen, and the apical constriction: evaluation by optical microscopy. J Endod. 2003; 29:214–219.

6. Dummer PM, McGinn JH, Rees DG. The position and topography of the apical canal constriction and apical foramen. Int Endod J. 1984; 17:192–198.

7. Martins JN, Marques D, Mata A, Caramês J. Clinical efficacy of electronic apex locators: systematic review. J Endod. 2014; 40:759–777.

8. Kobayashi C, Suda H. New electronic canal measuring device based on the ratio method. J Endod. 1994; 20:111–114.

9. Kara Tuncer A, Gerek M. Effect of working length measurement by electronic apex locator or digital radiography on postoperative pain: a randomized clinical trial. J Endod. 2014; 40:38–41.

10. de Vasconcelos BC, Veríssimo Chaves RD, Vivacqua-Gomes N, Candeiro GT, Bernardes RA, Vivan RR, Duarte MA. Ex vivo evaluation of the accuracy of electronic foramen locators in root canals with an obstructed apical foramen. J Endod. 2015; 41:1551–1554.

11. Schneider SW. A comparison of canal preparations in straight and curved root canals. Oral Surg Oral Med Oral Pathol. 1971; 32:271–275.

12. Ingle JI, Beveridge EE. Endodontics. 2nd ed. Philadelphia (PA): Lea & Febiger;1976. p. 179.

13. Guise GM, Goodell GG, Imamura GM. In vitro comparison of three electronic apex locators. J Endod. 2010; 36:279–281.

14. Khandewal D, Ballal NV, Saraswathi MV. Comparative evaluation of accuracy of 2 electronic Apex locators with conventional radiography: an ex vivo study. J Endod. 2015; 41:201–204.

15. Pagavino G, Pace R, Baccetti T. A SEM study of in vivo accuracy of the Root ZX electronic apex locator. J Endod. 1998; 24:438–441.

16. Haffner C, Folwaczny M, Galler K, Hickel R. Accuracy of electronic apex locators in comparison to actual length--an in vivo study. J Dent. 2005; 33:619–625.

17. Vasconcelos BC, Bueno Mde M, Luna-Cruz SM, Duarte MA, Fernandes CA. Accuracy of five electronic foramen locators with different operating systems: an ex vivo study. J Appl Oral Sci. 2013; 21:132–137.

18. Real DG, Davidowicz H, Moura-Netto C, Zenkner Cde L, Pagliarin CM, Barletta FB, de Moura AA. Accuracy of working length determination using 3 electronic apex locators and direct digital radiography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111:e44–e49.

19. Kim E, Marmo M, Lee CY, Oh NS, Kim IK. An in vivo comparison of working length determination by only root-ZX apex locator versus combining root-ZX apex locator with radiographs using a new impression technique. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 105:e79–e83.

20. 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 J. 2006; 39:408–414.

21. Parente LA, Levin MD, Vivan RR, Bernardes RA, Duarte MA, Vasconcelos BC. Efficacy of electronic foramen locators in controlling root canal working length during rotary instrumentation. Braz Dent J. 2015; 26:547–551.

22. 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; 45:552–556.