Analysis of Electronic Apex Locators in Human Teeth Diagnosed With Apical Periodontitis.

Norberto J Broon,Claudia Azucena Palafox-Sánchez,Israel Ceja,Diana Celeste Salazar Camarena,Carlos S Ramos,Mario Uribe,Alvaro Cruz,Carlos Estrela

doi:10.1590/0103-6440201902705

Abstract

Electronic apex locators (EAL) have been used to establish the working length (WL) in root canal treatment. In teeth diagnosed with apical periodontitis, resorption of tooth apical structures can lead to difficulties to obtain an appropriate WL. The aim was to compare the capacity of three EAL's (Root ZX II, Raypex 6 and Endo-Eze Quill) to locate the tip of the K-file between 0 to -0.5 mm from the apical foramen (AF) on teeth diagnosed with asymptomatic apical periodontitis (AAP). Electronic working length was performed on 60 roots with AAP. A K-file #15 was inserted in the root canal until the apical foramen (AF) was located, and followed was re-adjusted to -0.5 mm through observation in EAL display. The K-file was fixed to the tooth with composite and teeth were extracted. The 4 apical millimeters were worn out until the K-file could be seen and were prepared and measured its distance to AF in a scanning electron microscope. Appropriate WL was when the tip of the K-file was located between 0 to -0.5 mm from AF. Results: Root ZX II showed significant difference (p<0.01) with the other two EALs. Root ZX II presented the better performance than Raypex 6 or Endo-Eze Quill in teeth with AAP.

Highlights

The therapeutic protocol to removal of vital or necrotic tissue, microorganisms and their products is challenging to the root canal treatment successful [1]
It has difficulties and limitations. It does not allow observing the position of the apical foramen (AF) or identifying the cementum-dentin-canal zone (CDC), and the interpretation of the radiographic image is affected by superposition of anatomical structures [4]
The aim of this study was to compare the capacity of three electronic apex locator (EAL) to determine the position of the K file tip between 0.0 to -0.5 mm from the AF in teeth with Apical periodontitis (AP), because there is limited clinical evidence of its use in those teeth [10,12]

Summary

Introduction

The therapeutic protocol to removal of vital or necrotic tissue, microorganisms and their products is challenging to the root canal treatment successful [1]. The working length is established using radiographic and electronic methods [4]. Radiographic determination of WL has been used for many years. It does not allow observing the position of the apical foramen (AF) or identifying the cementum-dentin-canal zone (CDC), and the interpretation of the radiographic image is affected by superposition of anatomical structures [4]. Sunada [7] designed the first electronic apex locator (EAL) and called it “ohmmeter”. This device had operated under the electric resistance principle

Objectives

Methods

Results

Conclusion