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ACCURACY OF 3 ELECTRONIC APEX LOCATORS IN NONSURGICAL RETREATMENTS OF TEETH WITH ROOT-ENDS RESECTED AT DIFFERENT ANGLES: IN-VITRO STUDY

Year 2022, Volume: 25 Issue: 2, 137 - 141, 30.06.2022

Demet Altunbaş , Kerem Engin Akpınar , Fatma Kaya

https://doi.org/10.7126/cumudj.1103606

Abstract

Aim: The accuracy of three electronic apex locators (EALs) during retreatment of root-end resected teeth with different resection bevel angles were evaluated in the present study.
Materials and Methods: Forty mandibular premolar teeth were divided into two groups regarding resection bevel angle after root canal filling. In the first group, the apical 3 mm of each specimen was resected at a 0-degree bevel angle using a diamond bur. The resection bevel angle was approximately 45-degree in the second group. Electronic length measurements were obtained with a size 15 K-file advanced apically in dissolved gutta percha using Dentaport ZX, Propex Pixi, and Apit 15. The filling materials were then completely removed from the root canals, and the actual lengths up to the resection region were determined. The actual length was subtracted from the electronic length measurements for each specimen. Measurements were analyzed statistically using independent sample t-test, repeated-measures analysis of variance, and Bonferroni tests. The level of statistical significance was defined as P<0.05.
Results: In the 45-degree group, a significant difference was found between Propex Pixi and Apit 15. Measurements at 0- and 45-degree resection bevel angles were not statistically different from each other in any EAL groups.
Conclusions: The resection bevel angle did not affect the accuracy of the tested EALs. More accurate measurements were obtained with the Propex Pixi at a 45-degree resection bevel angle compared with the Apit 15.

Keywords

Electronic apex locator Resection bevel angle Retreatment Root canal.

Supporting Institution

the Scientific Research Project Fund of Sivas Cumhuriyet University

Project Number

DİŞ-227

Thanks

This study was supported by the Scientific Research Project Fund of Sivas Cumhuriyet University under the project number DİŞ-227. The authors thank Dr. Ziynet Çınar for statistical analysis.

References

  • 1. Nepal M, Shubham S, Tripathi R, Khadka J, Kunwar D, Gautam V, et al. Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study. BMC Oral Health 2020;20:37.
  • 2. Roda RS, Gettleman BH. Nonsurgical Retreatment. In: Hargreaves KM, Berman LH, editors. Cohen's Pathways of the Pulp. 11 ed. St. Louis: Mosby/Elsevier; 2016. p. 799-931.
  • 3. Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S. Clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars. J Endod 2002;28:477-479.
  • 4. Chugal NM, Clive JM, Spångberg LS. Endodontic infection: some biologic and treatment factors associated with outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:81-90.
  • 5. McGuigan MB, Louca C, Duncan HF. The impact of fractured endodontic instruments on treatment outcome. Br Dent J 2013;214:285-289.
  • 6. Yamaguchi M, Noiri Y, Itoh Y, Komichi S, Yagi K, Uemura R, et al. Factors that cause endodontic failures in general practices in Japan. BMC Oral Health 2018;18:70.
  • 7. Song M, Kim HC, Lee W, Kim E. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod 2011;37:1516-1519.
  • 8. Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod 2011;37:895-902.
  • 9. Torabinejad M, White SN. Endodontic treatment options after unsuccessful initial root canal treatment: Alternatives to single-tooth implants. J Am Dent Assoc 2016;147:214-220.
  • 10. Siqueira JF, Jr., Rôças IN, Ricucci D, Hülsmann M. Causes and management of post-treatment apical periodontitis. Br Dent J 2014;216:305-312.
  • 11. Beikler T, Flemmig TF. EAO consensus conference: economic evaluation of implant-supported prostheses. Clin Oral Implants Res 2015;26 Suppl 11:57-63.
  • 12. Uzun O, Topuz O, Tinaz AC, Alacam T. Apical accuracy of two apex-locating handpieces in root canal retreatments of root-end resected teeth. J Endod 2007;33:1444-1446.
  • 13. ElAyouti A, Kimionis I, Chu AL, Lost C. Determining the apical terminus of root-end resected teeth using three modern apex locators: a comparative ex vivo study. Int Endod J 2005;38:827-833.
  • 14. Mente J, Leo M, Michel A, Gehrig H, Saure D, Pfefferle T. Outcome of orthograde retreatment after failed apicoectomy: use of a mineral trioxide aggregate apical plug. J Endod 2015;41:613-620.
  • 15. Serna-Peña G, Gomes-Azevedo S, Flores-Treviño J, Madla-Cruz E, Rodríguez-Delgado I, Martínez-González G. In Vivo Evaluation of 3 Electronic Apex Locators: Root ZX Mini, Apex ID, and Propex Pixi. J Endod 2020;46:158-161.
  • 16. Lucena C, López JM, Martín JA, Robles V, González-Rodríguez MP. Accuracy of working length measurement: electronic apex locator versus cone-beam computed tomography. Int Endod J 2014;47:246-256.
  • 17. Mancini M, Palopoli P, Iorio L, Conte G, Cianconi L. Accuracy of an electronic apex locator in the retreatment of teeth obturated with plastic or cross-linked gutta-percha carrier-based materials: an ex vivo study. J Endod 2014;40:2061-2065.
  • 18. Tufenkci P, Kalayci A. Evaluation of the accuracy of different apex locators in determining the working length during root canal retreatment. J Dent Res Dent Clin Dent Prospects 2020;14:125-129.
  • 19. Altunbaş D, Kuştarcı A, Toyoğlu M. The Influence of Various Irrigants on the Accuracy of 2 Electronic Apex Locators in Locating Simulated Root Perforations. J Endod 2017;43:439-442.
  • 20. OSADA APIT 15 CATALOG [Internet]. Available from: http://www.osada-electric.co.jp/dental/global/asia/post_img/Apit%2015%20catalog.pdf (cited 2021 April 20). In.
  • 21. Hülsmann M, Tulus G. Non‐surgical retreatment of teeth with persisting apical periodontitis following apicoectomy: decision making, treatment strategies and problems, and case reports. Endodontic Topics 2016;34:64-89.
  • 22. Bernardo R, Alves LS, Bruno AMV, Coutinho TMC, Gusman H. The accuracy of electronic apex locators for determining working length: An in vitro study with artificial teeth. Aust Endod J 2020;47:217-221.
  • 23. Kang JA, Kim SK. Accuracies of seven different apex locators under various conditions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e57-62.
  • 24. Connert T, Judenhofer MS, Hülber JM, Schell S, Mannheim JG, Pichler BJ, et al. Evaluation of the accuracy of nine electronic apex locators by using Micro-CT. Int Endod J 2018;51:223-232.
  • 25. Marigo L, Gervasi GL, Somma F, Squeo G, Castagnola R. Comparison of two electronic apex locators on human cadavers. Clin Oral Investig 2016;20:1547-1550.
  • 26. Ebrahim AK, Wadachi R, Suda H. In vitro evaluation of the accuracy of five different electronic apex locators for determining the working length of endodontically retreated teeth. Aust Endod J 2007;33:7-12.
  • 27. Cimilli H, Aydemir S, Arican B, Mumcu G, Chandler N, Kartal N. Accuracy of the Dentaport ZX apex locator for working length determination when retreating molar root canals. Aust Endod J 2014;40:2-5.
  • 28. Kim YJ, Chandler NP. Determination of working length for teeth with wide or immature apices: a review. Int Endod J 2013;46:483-491.
  • 29. Hulsmann M, Pieper K. Use of an electronic apex locator in the treatment of teeth with incomplete root formation. Endod Dent Traumatol 1989;5:238-241.
  • 30. Herrera M, Abalos C, Lucena C, Jimenez-Planas A, Llamas R. Critical diameter of apical foramen and of file size using the Root ZX apex locator: an in vitro study. J Endod 2011;37:1306-1309.
  • 31. Angerame D, De Biasi M, Marigo L, Castagnola R, Somma F, Castaldo A. Influence of simulated apical resorption following orthodontic treatment on working length determination: an in vitro study. Eur J Paediatr Dent 2014;15:288-292.
  • 32. Beltrame AP, Triches TC, Sartori N, Bolan M. Electronic determination of root canal working length in primary molar teeth: an in vivo and ex vivo study. Int Endod J 2011;44:402-406.
  • 33. 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.
  • 34. Alves AM, Felippe MC, Felippe WT, Rocha MJ. Ex vivo evaluation of the capacity of the Tri Auto ZX to locate the apical foramen during root canal retreatment. Int Endod J 2005;38:718-724.
  • 35. Fouad AF, Rivera EM, Krell KV. Accuracy of the Endex with variations in canal irrigants and foramen size. J Endod 1993;19:63-67.
  • 36. Ebrahim AK, Yoshioka T, Kobayashi C, Suda H. The effects of file size, sodium hypochlorite and blood on the accuracy of Root ZX apex locator in enlarged root canals: an in vitro study. Aust Dent J 2006;51:153-157.
  • 37. Ebrahim AK, Wadachi R, Suda H. Ex vivo evaluation of the ability of four different electronic apex locators to determine the working length in teeth with various foramen diameters. Aust Dent J 2006;51:258-262.

Kök Uçları Farklı Açılarda Rezeke Edilmiş Dişlerin Cerrahi Olmayan Yeniden Tedavilerinde 3 Elektronik Apeks Bulucunun Doğruluğu: In-Vitro Çalışma

Year 2022, Volume: 25 Issue: 2, 137 - 141, 30.06.2022

Demet Altunbaş , Kerem Engin Akpınar , Fatma Kaya

https://doi.org/10.7126/cumudj.1103606

Abstract

Amaç: Bu çalışmada, farklı rezeksiyon eğim açılarıyla kök ucu rezeke edilmiş dişlerin yeniden tedavileri sırasında üç elektronik apeks bulucunun (EAB) doğruluğu değerlendirildi.
Gereç ve Yöntemler: Kırk mandibular premolar diş rezeksiyon eğim açısına göre kanal dolgusu sonrası iki gruba ayrıldı. Birinci grupta, her örneğin apikal 3 mm'si elmas frez kullanılarak 0-derecelik bir eğim açısında rezeke edildi. İkinci grupta rezeksiyon eğim açısı yaklaşık 45-dereceydi. Elektronik uzunluk ölçümleri, Dentaport ZX, Propex Pixi ve Apit 15 kullanılarak çözünmüş güta perka içinde apikal olarak ilerletilmiş 15 numaralı bir K-tipi eğeyle elde edildi. Daha sonra dolgu maddeleri kök kanallarından tamamen uzaklaştırıldı ve rezeksiyon bölgesine kadar olan gerçek kanal uzunlukları belirlendi. Her örnek için gerçek uzunluk, elektronik uzunluk ölçümlerinden çıkarıldı. Ölçümler independent sample t-test, tekrarlı ölçümlerde varyans analizi ve Bonferroni testleri kullanılarak istatistiksel olarak analiz edildi. İstatistiksel anlamlılık düzeyi P<0.05 olarak tanımlandı.
Bulgular: 45-derece grubunda Propex Pixi ve Apit 15 arasında anlamlı fark bulundu. 0- ve 45-derecelik rezeksiyon eğim açılarındaki ölçümler, hiçbir EAB grubunda istatistiksel olarak birbirinden farklı değildi.
Sonuçlar: Rezeksiyon eğim açısı, test edilen EAB'ların doğruluğunu etkilemedi. Propex Pixi ile 45-derecelik rezeksiyon eğim açısında Apit 15'e göre daha doğru ölçümler elde edildi.

Keywords

Elektronik apeks bulucu Rezeksiyon eğim açısı Yeniden tedavi Kök kanalı.

Project Number

DİŞ-227

References

  • 1. Nepal M, Shubham S, Tripathi R, Khadka J, Kunwar D, Gautam V, et al. Spectrophotometric analysis evaluating apical microleakage in retrograde filling using GIC, MTA and biodentine: an in-vitro study. BMC Oral Health 2020;20:37.
  • 2. Roda RS, Gettleman BH. Nonsurgical Retreatment. In: Hargreaves KM, Berman LH, editors. Cohen's Pathways of the Pulp. 11 ed. St. Louis: Mosby/Elsevier; 2016. p. 799-931.
  • 3. Wolcott J, Ishley D, Kennedy W, Johnson S, Minnich S. Clinical investigation of second mesiobuccal canals in endodontically treated and retreated maxillary molars. J Endod 2002;28:477-479.
  • 4. Chugal NM, Clive JM, Spångberg LS. Endodontic infection: some biologic and treatment factors associated with outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:81-90.
  • 5. McGuigan MB, Louca C, Duncan HF. The impact of fractured endodontic instruments on treatment outcome. Br Dent J 2013;214:285-289.
  • 6. Yamaguchi M, Noiri Y, Itoh Y, Komichi S, Yagi K, Uemura R, et al. Factors that cause endodontic failures in general practices in Japan. BMC Oral Health 2018;18:70.
  • 7. Song M, Kim HC, Lee W, Kim E. Analysis of the cause of failure in nonsurgical endodontic treatment by microscopic inspection during endodontic microsurgery. J Endod 2011;37:1516-1519.
  • 8. Gillen BM, Looney SW, Gu LS, Loushine BA, Weller RN, Loushine RJ, et al. Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod 2011;37:895-902.
  • 9. Torabinejad M, White SN. Endodontic treatment options after unsuccessful initial root canal treatment: Alternatives to single-tooth implants. J Am Dent Assoc 2016;147:214-220.
  • 10. Siqueira JF, Jr., Rôças IN, Ricucci D, Hülsmann M. Causes and management of post-treatment apical periodontitis. Br Dent J 2014;216:305-312.
  • 11. Beikler T, Flemmig TF. EAO consensus conference: economic evaluation of implant-supported prostheses. Clin Oral Implants Res 2015;26 Suppl 11:57-63.
  • 12. Uzun O, Topuz O, Tinaz AC, Alacam T. Apical accuracy of two apex-locating handpieces in root canal retreatments of root-end resected teeth. J Endod 2007;33:1444-1446.
  • 13. ElAyouti A, Kimionis I, Chu AL, Lost C. Determining the apical terminus of root-end resected teeth using three modern apex locators: a comparative ex vivo study. Int Endod J 2005;38:827-833.
  • 14. Mente J, Leo M, Michel A, Gehrig H, Saure D, Pfefferle T. Outcome of orthograde retreatment after failed apicoectomy: use of a mineral trioxide aggregate apical plug. J Endod 2015;41:613-620.
  • 15. Serna-Peña G, Gomes-Azevedo S, Flores-Treviño J, Madla-Cruz E, Rodríguez-Delgado I, Martínez-González G. In Vivo Evaluation of 3 Electronic Apex Locators: Root ZX Mini, Apex ID, and Propex Pixi. J Endod 2020;46:158-161.
  • 16. Lucena C, López JM, Martín JA, Robles V, González-Rodríguez MP. Accuracy of working length measurement: electronic apex locator versus cone-beam computed tomography. Int Endod J 2014;47:246-256.
  • 17. Mancini M, Palopoli P, Iorio L, Conte G, Cianconi L. Accuracy of an electronic apex locator in the retreatment of teeth obturated with plastic or cross-linked gutta-percha carrier-based materials: an ex vivo study. J Endod 2014;40:2061-2065.
  • 18. Tufenkci P, Kalayci A. Evaluation of the accuracy of different apex locators in determining the working length during root canal retreatment. J Dent Res Dent Clin Dent Prospects 2020;14:125-129.
  • 19. Altunbaş D, Kuştarcı A, Toyoğlu M. The Influence of Various Irrigants on the Accuracy of 2 Electronic Apex Locators in Locating Simulated Root Perforations. J Endod 2017;43:439-442.
  • 20. OSADA APIT 15 CATALOG [Internet]. Available from: http://www.osada-electric.co.jp/dental/global/asia/post_img/Apit%2015%20catalog.pdf (cited 2021 April 20). In.
  • 21. Hülsmann M, Tulus G. Non‐surgical retreatment of teeth with persisting apical periodontitis following apicoectomy: decision making, treatment strategies and problems, and case reports. Endodontic Topics 2016;34:64-89.
  • 22. Bernardo R, Alves LS, Bruno AMV, Coutinho TMC, Gusman H. The accuracy of electronic apex locators for determining working length: An in vitro study with artificial teeth. Aust Endod J 2020;47:217-221.
  • 23. Kang JA, Kim SK. Accuracies of seven different apex locators under various conditions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:e57-62.
  • 24. Connert T, Judenhofer MS, Hülber JM, Schell S, Mannheim JG, Pichler BJ, et al. Evaluation of the accuracy of nine electronic apex locators by using Micro-CT. Int Endod J 2018;51:223-232.
  • 25. Marigo L, Gervasi GL, Somma F, Squeo G, Castagnola R. Comparison of two electronic apex locators on human cadavers. Clin Oral Investig 2016;20:1547-1550.
  • 26. Ebrahim AK, Wadachi R, Suda H. In vitro evaluation of the accuracy of five different electronic apex locators for determining the working length of endodontically retreated teeth. Aust Endod J 2007;33:7-12.
  • 27. Cimilli H, Aydemir S, Arican B, Mumcu G, Chandler N, Kartal N. Accuracy of the Dentaport ZX apex locator for working length determination when retreating molar root canals. Aust Endod J 2014;40:2-5.
  • 28. Kim YJ, Chandler NP. Determination of working length for teeth with wide or immature apices: a review. Int Endod J 2013;46:483-491.
  • 29. Hulsmann M, Pieper K. Use of an electronic apex locator in the treatment of teeth with incomplete root formation. Endod Dent Traumatol 1989;5:238-241.
  • 30. Herrera M, Abalos C, Lucena C, Jimenez-Planas A, Llamas R. Critical diameter of apical foramen and of file size using the Root ZX apex locator: an in vitro study. J Endod 2011;37:1306-1309.
  • 31. Angerame D, De Biasi M, Marigo L, Castagnola R, Somma F, Castaldo A. Influence of simulated apical resorption following orthodontic treatment on working length determination: an in vitro study. Eur J Paediatr Dent 2014;15:288-292.
  • 32. Beltrame AP, Triches TC, Sartori N, Bolan M. Electronic determination of root canal working length in primary molar teeth: an in vivo and ex vivo study. Int Endod J 2011;44:402-406.
  • 33. 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.
  • 34. Alves AM, Felippe MC, Felippe WT, Rocha MJ. Ex vivo evaluation of the capacity of the Tri Auto ZX to locate the apical foramen during root canal retreatment. Int Endod J 2005;38:718-724.
  • 35. Fouad AF, Rivera EM, Krell KV. Accuracy of the Endex with variations in canal irrigants and foramen size. J Endod 1993;19:63-67.
  • 36. Ebrahim AK, Yoshioka T, Kobayashi C, Suda H. The effects of file size, sodium hypochlorite and blood on the accuracy of Root ZX apex locator in enlarged root canals: an in vitro study. Aust Dent J 2006;51:153-157.
  • 37. Ebrahim AK, Wadachi R, Suda H. Ex vivo evaluation of the ability of four different electronic apex locators to determine the working length in teeth with various foramen diameters. Aust Dent J 2006;51:258-262.
There are 37 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Demet Altunbaş 0000-0002-7532-4785

Kerem Engin Akpınar 0000-0001-8900-9519

Fatma Kaya 0000-0002-7687-6397

Project Number DİŞ-227
Publication Date June 30, 2022
Submission Date April 14, 2022
Published in Issue Year 2022Volume: 25 Issue: 2

Cite

EndNote Altunbaş D, Akpınar KE, Kaya F (June 1, 2022) ACCURACY OF 3 ELECTRONIC APEX LOCATORS IN NONSURGICAL RETREATMENTS OF TEETH WITH ROOT-ENDS RESECTED AT DIFFERENT ANGLES: IN-VITRO STUDY. Cumhuriyet Dental Journal 25 2 137–141.
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