Influence of Different Coronal Preflaring Protocols on Electronic Foramen Locators Precision

Abstract

The aim of this study was to evaluate the influence of different coronal preflaring protocols (absent, conservative and conventional) on the accuracy of Root ZX II, Raypex 6, and RomiApex A-15 electronic foramen locators (EFLs). Twenty mandibular molars with Vertucci’s type IV mesial roots were subjected to endodontic exploration and foraminal patency confirmation. Under 16x magnification, its real lengths (RL) were measured and registered (RL1). The canals were then irrigated with 2.5% sodium hypochlorite and electronically measured (EM1) employing the alginate model; all measurements were performed in triplicate by a blind operator using adjusted endodontic hand-files introduced until the apex foramen. Coronal preflaring procedures were sequentially performed with #25/.06 (conservative) and #25/.12 (conventional) instruments; new RLs extents were performed after each coronal preparation protocol (RL2/RL3), as same as electronic measurements (EM2/EM3). The devices error (mm) was evaluated considering the difference between RLs and EMs at each preparation stage; their precision was stablished adopting ±0.5 mm as tolerance margin. The EFLs error significantly reduced after conventional coronal preflaring protocol (p<0.05), which not occur after the conservative one. The best precisions values were noted after conventional preparation as 90% (Root ZX II), 97.5% (Raypex 6), and 92.5% (RomiApex A-15). No significant differences were found in EFLs comparisons, regardless of the coronal protocol tested (p>0.05). Under the conditions tested it can be concluded that the EFLs evaluated were precise. Moreover, the preflaring protocols influences its accuracy’s, where the less conservative one produced the best results.

Correlation between the major apical foramen and readings from display’s numbers of two electronic apex locators: An ex vivo study

“…Several researchers have shown the accuracy of different apex locators to determine CRT, ranging from 89% to 97.8% for Root ZX II (Aguiar et al 2017;Saraf et al 2017;Cury et al 2021;Melo et al 2020) and from 92,5% a 95,6% for Romiapex A-15 (Saraf et al 2017;Melo et al 2020), both devices used in the present study. In the present study, the Root ZX II and RomiApex A-15 were accurate in locating the apical foramen and the distance of 0.5 mm close from the apical foramen in 93.5% of the times.…”

“…Cone-beam computed tomography is an accurate method that should be used for odontometry, only if the dentist already has this exam indicated for other treatments, avoiding unnecessary radiation to the patient (Connert et al 2018;Paterson et. al 2020;Mahmoud et al 2021) Therefore, the simplest and most used method to obtain the location of the apical foramen is the use of electronic apex locators (Melo et al, 2020;Pham 2021).…”

Evaluation of the effect of irrigants on the accuracy and repeatability of three electronic apex locators: an ex vivo study

“…Studies evaluating electronic apex locators, which do not use a mounting model, may be conducted according to the adjustment of a silicone stop of the measurement file to a reference point in the dental crown, after which the distance from the silicone stop to the file tip is measured. This type of method has been utilized in many other studies (Piasecki et al 2016;Melo et al 2020;Saritha et al 2020;Iparraguirre Nuñovero et al 2021). However, may lead to inaccurate measurements due to the poor adaptation of the silicone stop to the reference point because of movements during measurement, the absence of a parallel relation between the long axis of the file and the reference.…”

“…The present study demonstrated the accuracy of the Mini Apex Locator, iPex and Root ZX II to identify the apical constriction in the presence of Chlorhexidine and sodium hypochlorite in a range of 77.4% to 90.3%,. Some authors concluded that EALs may accurately determine working length in 90% to 100% of root canals with completely formed apices (Bolbolian et al, 2018;Melo et al, 2020;Serna-Peña et al 2020), however, these cited studies did not utilize a mounting model.…”

“…Root ZX is considered the gold standard for locators, several studies have shown satisfactory results (Piasecki et al 2016;Melo et al 2020), even with its use with different irrigating solutions (Bolbolian et al 2018). However, when comparing the influence of different irrigation solutions, commonly utilized in endodontics on the accuracy of Root ZX and Mini Apex Locator, different accuracy results were found (Mull et al 2012).…”