Evaluation of three instrumentation techniques at the precision of apical stop and apical sealing of obturation

Abstract

ObjectiveThe aim of this study was to investigate the ability of two NiTi rotary apical preparation techniques used with an electronic apex locator-integrated endodontic motor and a manual technique to create an apical stop at a predetermined level (0.5 mm short of the apical foramen) in teeth with disrupted apical constriction, and to evaluate microleakage following obturation in such prepared teeth. Material and Methods: 85 intact human mandibular permanent incisors with single root canal were accessed and the apical constriction was disrupted using a #25 K-file. The teeth were embedded in alginate and instrumented to #40 using rotary Lightspeed or S-Apex techniques or stainless-steel K-files. Distance between the apical foramen and the created apical stop was measured to an accuracy of 0.01 mm. In another set of instrumented teeth, root canals were obturated using gutta-percha and sealer, and leakage was tested at 1 week and 3 months using a fluid filtration device. ResultsAll techniques performed slightly short of the predetermined level. Closest preparation to the predetermined level was with the manual technique and the farthest was with S-Apex. A significant difference was found between the performances of these two techniques (p<0.05). Lightspeed ranked in between. Leakage was similar for all techniques at either period. However, all groups leaked significantly more at 3 months compared to 1 week (p<0.05). ConclusionsDespite statistically significant differences found among the techniques, deviations from the predetermined level were small and clinically acceptable for all techniques. Leakage following obturation was comparable in all groups.

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

“…Ex vivo experimental methods for studying the accuracy of EALs often use electroconductive materials such as alginate, gelatine, agar, or saline media 2 - 7 , 12 , 26 , 30 . These embedding media may reproduce the impedance values of human tissues, thus simulating the clinical situation.…”

Validity of longitudinal sections for determining the apical constriction

“…, Genç et al . ). On the other hand, extending the root canal preparation to the foramen will debride the canal along its entire length and will allow disinfection of the complex apical anatomy more easily (Schilder , Martínez‐Lozano et al .…”

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

“…Precise root canal length determination using the apical constriction or the apical foramen (AF) as references is an extremely relevant factor for the success of endodontic treatments 10 , 11 , 21 , 23 . 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 .…”