An in vivo radiographic evaluation of the accuracy of Apex and iPex electronic Apex locators

Paludo, Laura; Souza, Sophia Lopes de; Só, Marcus Vinícius Reis; Rosa, Ricardo Abreu da; Vier-Pelisser, Fabiana Vieira; Duarte, Marco Antônio Húngaro

doi:10.1590/s0103-64402012000100010

Cited by 13 publications

(13 citation statements)

References 23 publications

(37 reference statements)

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“…Electronic root canal length measurement devices (ERCLMDs) are considered efficient tools for this purpose 12,15,18,26,28 , achieving precision percentages upwards of 80% ex vivo 2,4,6,9,17-20,23-26 and in vivo 8,23,27,29,30 .…”

Section: Introductionmentioning

confidence: 99%

“…However, little information is available regarding its technical specifications, aside from the fact that it utilizes two different signal frequencies. Both the Mini Apex Locator and the iPex have demonstrated satisfactory clinical results, despite the relative lack of information on their operating mechanisms, especially with regards to how these devices electronically interpret the impedance values obtained in the different frequencies during measurements within the canal 4,16,18,23,24,26 .…”

Section: Introductionmentioning

confidence: 99%

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Accuracy of five electronic foramen locators with different operating systems: an ex vivo study

Vasconcelos

Bueno²,

Luna-Cruz

et al. 2013

J. Appl. Oral Sci.

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Objective:The aim of this study was to evaluate, ex vivo, the precision of five electronic root canal length measurement devices (ERCLMDs) with different operating systems: the Root ZX, Mini Apex Locator, Propex II, iPex, and RomiApex A-15, and the possible influence of the positioning of the instrument tips short of the apical foramen.Material and Methods:Forty-two mandibular bicuspids had their real canal lengths (RL) previously determined. Electronic measurements were performed 1.0 mm short of the apical foramen (-1.0), followed by measurements at the apical foramen (0.0). The data resulting from the comparison of the ERCLMD measurements and the RL were evaluated by the Wilcoxon and Friedman tests at a significance level of 5%.Results:Considering the measurements performed at 0.0 and -1.0, the precision rates for the ERCLMDs were: 73.5% and 47.1% (Root ZX), 73.5% and 55.9% (Mini Apex Locator), 67.6% and 41.1% (Propex II), 61.7% and 44.1% (iPex), and 79.4% and 44.1% (RomiApex A-15), respectively, considering ±0.5 mm of tolerance. Regarding the mean discrepancies, no differences were observed at 0.0; however, in the measurements at -1.0, the iPex, a multi-frequency ERCLMD, had significantly more discrepant readings short of the apical foramen than the other devices, except for the Propex II, which had intermediate results. When the ERCLMDs measurements at -1.0 were compared with those at 0.0, the Propex II, iPex and RomiApex A-15 presented significantly higher discrepancies in their readings.Conclusions:Under the conditions of the present study, all the ERCLMDs provided acceptable measurements at the 0.0 position. However, at the -1.0 position, the ERCLMDs had a lower precision, with statistically significant differences for the Propex II, iPex, and RomiApex A-15.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Accuracy of five electronic foramen locators with different operating systems: an ex vivo study

Vasconcelos

Bueno²,

Luna-Cruz

et al. 2013

J. Appl. Oral Sci.

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“…Several studies 19,30,34 compared the accuracy of different models of EALs with radiographic root canal length determination and showed that the electronic methods provided the best results. In addition, the EALs have the advantage of reducing the number of radiographs required to establish the apical limit of root canal instrumentation in clinical practice 11,23 .…”

Section: Introductionmentioning

confidence: 99%

Effect of pre-flaring and file size on the accuracy of two electronic apex locators

et al. 2012

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ObjectiveThis ex vivo study evaluated the effect of pre-flaring and file size on the accuracy of the Root ZX and Novapex electronic apex locators (EALs). Material and methodsThe actual working length (WL) was set 1 mm short of the apical foramen in the palatal root canals of 24 extracted maxillary molars. The teeth were embedded in an alginate mold, and two examiners performed the electronic measurements using #10, #15, and #20 K-files. The files were inserted into the root canals until the "0.0" or ''APEX'' signals were observed on the LED or display screens for the Novapex and Root ZX, respectively, retracting to the 1.0 mark. The measurements were repeated after the pre-flaring using the S1 and SX Pro-Taper instruments. Two measurements were performed for each condition and the means were used. Intra-class correlation coefficients (ICCs) were calculated to verify the intra- and inter-examiner agreement. The mean differences between the WL and electronic length values were analyzed by the three-way ANOVA test (p<0.05). ResultsICCs were high (>0.8) and the results demonstrated a similar accuracy for both EALs (p>0.05). Statistically significant accurate measurements were verified in the pre-flared canals, except for the Novapex using a #20 K-file. ConclusionsThe tested EALs showed acceptable accuracy, whereas the pre-flaring procedure revealed a more significant effect than the used file size.

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“…Recent studies have shown great performance of electronic apex locators (12,13). However, the most common method to determine working length combines knowledge of root lengths, tactile discrimination, assessment of a preoperative radiograph and a radiograph taken with files placed in the root canal (14).…”

Section: Discussionmentioning

confidence: 99%

Gray scale inversion in digital image for measurement of tooth length

et al. 2012

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The aim of this study was to assess the applicability of gray scale inversion in performing digital linear endodontic measurements. Standardized digital images were taken of 40 extracted human permanent single-rooted teeth with K-files size 15 placed at different lengths in the root canal, using the CDR Wireless ® digital system. All images were treated with Positive, a digital tool that inverts the grayscale value. Eight radiologists measured the distance between the lower limit of the rubber stop and the tip of the file on both original and positive images. After 15 days, they repeated this procedure in 50% of the image samples. The intra-and inter-examiner agreement was analyzed by intraclass correlation test, and the comparison between the two image groups and the actual lengths by the Student's t-test (α=0.05). Intra-and inter-examiner evaluation showed high reproducibility (r>0.95) of both original and positive images. No statistically significant differences (p>0.05) were found between measurements performed on original and positive images, but both differed significantly from the actual lengths (p<0.05). Gray scale inversion has low applicability in measuring endodontic files, since it did not improve the accuracy of measurements.

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An in vivo radiographic evaluation of the accuracy of Apex and iPex electronic Apex locators

Cited by 13 publications

References 23 publications

Accuracy of five electronic foramen locators with different operating systems: an ex vivo study

Accuracy of five electronic foramen locators with different operating systems: an ex vivo study

Effect of pre-flaring and file size on the accuracy of two electronic apex locators

Gray scale inversion in digital image for measurement of tooth length

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