Abstract
IntroductionThe detection of possible root canal perforations caused during a metal post placement is frequently difficult to diagnose. The aim of this study was to investigate the accuracy of apex locators to diagnose such perforations.Materials and methodsThirty mesiolingual root canals of extracted mandibular molars were instrumented (30/.04) and a post space was prepared. A root canal perforation was intentionally made at the bi-furcation (n = 15). Metal posts were cemented in 15 perforated and 15 non-perforated root canals. The teeth roots were embedded in an agar-agar solution. The resulting measurements (“short” or “beyond” the apex) disclosed if a perforation could be identified with five different apex locators (ProPex II, Elements Apex Locator, Apex NRG, Raypex 5 and Raypex 6). The sensitivity and specificity (95% interval confidence) were calculated.ResultsAll devices excluded the absence of perforations (100% with 95% confidence interval [78%; 100%] specificity). The Apex NRG and Raypex 6 detected all perforations (100% with 95% confidence interval [78%; 100%] sensitivity). The ProPex II, Elements Apex Locator, and Raypex 5 detected 14 out of 15 perforations (93% with 95% confidence interval [68%; 100%] sensitivity).ConclusionsAll devices determined root canal perforations, due to metallic posts, within clinical acceptable ranges.
Highlights
The detection of possible root canal perforations caused during a metal post placement is frequently difficult to diagnose
The aim of this study was to investigate with an ex-vivo model the accuracy of different electronic apex locators when diagnosing root perforations due to placement of metal posts
In all 15 mesiolingual root canals in which the metal post was within the root canal limits, all electronic devices showed a “short measurement”; accurately excluding perforations when they were not present (100% specificity; 95% confidence interval [78%; 100%])
Summary
The detection of possible root canal perforations caused during a metal post placement is frequently difficult to diagnose. Different authors [19,20,21] have suggested the employment of an apex locator to detect a root perforation when a metal post is placed. If effective, this precaution would allow the clinician to plan the endodontic re-treatment; tooth disassembling prior to being astounded by the circumstances and having to immediately implement adequate treatment precautions. The aim of this study was to investigate with an ex-vivo model the accuracy of different electronic apex locators when diagnosing root perforations due to placement of metal posts
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