Influence of the Maxillary Sinus on the Accuracy of the Root ZX Apex Locator: An Ex Vivo Study.

Roula El Hachem,Alfred Naaman,Carla Zogheib,Nadim Mokbel,Elie Wassef,Richard Abboud,Nada El Osta

doi:10.3390/dj7010003

Abstract

This study evaluated the accuracy of the Root ZX (J. Morita, Tokyo, Japan) electronic apex locator in determining the working length when palatal maxillary molar roots are in a relationship with the sinus. Seventeen human maxillary molars with vital pulp were scheduled for an extraction and implant placement as part of a periodontal treatment plan. The access cavity was prepared, and a #10 K file (Dentsply Maillefer, Ballaigues, Switzerland) was inserted into the palatal root using the Root ZX apex locator in order to determine the electronic working length (EWL); then, the teeth were extracted. To determine the real working length (RWL), a #10 K file was introduced into the root canal until its tip touched a glass plate. EWL and RWL were compared. Images reconstructed with CBCT (cone beam computerized tomography) revealed that eight palatal roots were related to the maxillary sinus, whereas nine were not. The results showed a significant difference between the EWL and the RWL of the palatal roots related to the sinus (p < 0.001). No significant difference was observed in measurements of roots not in contact with the sinus (p > 0.05). Within the study limitations, the reliability of Root ZX was influenced by the relationship of the roots with the maxillary sinus.

Highlights

The elimination of microorganisms and pulp tissue from the root canal system is a crucial step for endodontic success [1,2], and such treatment should be confined within the roots [3,4]
It is sometimes tricky to precisely determine the root canal preparation length using periapical radiographs, since they are subject to distortion, are sensitive in interpretation, and they only give a two-dimensional image of the three-dimensional roots [6]
The null hypothesis tested was that there are no significant differences in the reliability of the Root ZX between the roots whether they are in contact or not in contact with the maxillary sinus

Summary

Introduction

The elimination of microorganisms and pulp tissue from the root canal system is a crucial step for endodontic success [1,2], and such treatment should be confined within the roots [3,4]. This can only be achieved when the root canal length is determined with accuracy. The latest generation of these devices determines the WL by measuring the variation of impedance by using different frequencies in the instrument tip within the canal [10]. Tokyo, Japan) is an accurate, third-generation EAL that expresses the quotient between the impedances of two frequencies

Objectives

Methods

Conclusion