Accuracy of Root ZXII, E-PEX and FIND apex locators in teeth with vital pulp: an in vivo study

Abstract

This research evaluated, in vivo, the accuracy of three electronic apex locators -EALs (Root ZXII, E-PEX and FIND) in teeth with vital pulp submitted to biopulpectomy, preserving the periodontal stump. For this study, 90 single-rooted teeth with extraction indication were selected. After positive pulpal cold sensitivity test, pulp chamber access was performed. The cervical and middle thirds of root canals were instrumented with Reciproc R25, and the K#15 file was used as a standard instrument to determine working length, forming 2 groups: Constriction (insertion of the instrument until the apical constriction limit) and Foramen (insertion of the instrument until the foramen and then repositioning at constriction, without removing the file from the canal). The hand file was stabilized with a light-cured flow resin. After extraction, the samples were analyzed through microCT SkyScan 1272, with CTAN software, which evaluated the proximity between the tip of the file to the apical constriction, providing data for comparative analysis using Kruskal-Wallis and Dunn tests (p<0.05). There was a statistically significant difference in the abilities of the EALs to detect the apical constriction after reaching the foramen with Root ZX II showing higher accuracy (89%). However, there was no difference in the accuracy of the three EALs in detecting the apical constriction without reaching the foramen. Based on the present results, we conclude that EALs may show accurate measures in detecting apical constriction and foramen, even without damaging the periodontal stump in biopulpectomy.

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

“…The accuracy of apex locator measurements increases as the file approaches the apical foramen. As in the present study, measurements at the 0.5 and 0.0 display numbers were considered accurate by other authors (Higa et al 2009;Piasecki et al 2018;Serna-Peña et al 2020;Cury et al 2021;Bernardes et al 2022). Other studies found more accurate results when EAL's measurements were obtained at 0.0 in the apical foramen, and worse results at 1mm short of the apical foramen (Saxena et al 2017;Adorno et al 2021).…”

“…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.…”

“…Several studies have evaluated the accuracy of different apex locators by calculating the distance between the file tip to the 0.0 or 0.5 number, the apical foramen, or the apical constriction (Piasecki et al 2018;Bernardes et al 2021;Cury et al 2021). However, the use of EALs to determine the major foramen can led to overestimation of the working length (Connert et al 2018).…”