The influence of two forms of chlorhexidine on the accuracy of contemporary electronic apex locators

Abstract

BackgroundAccurate determination of working length (WL) is crucial for the success of endodontic therapy. The aim of this study was to determine the influence of 2% chlorhexidine digluconate solution, 2% chlorhexidine digluconate gel and 2% hypochlorite solution on the accuracy of two devices: the Raypex 5 and the ApexDal.MethodsTwenty-nine single-rooted human teeth were used in this study. The crowns were cut horizontally and embedded in an alginate mass. In each tooth, six endodontic measurements were made using two electronic apex locators (EALs): a Raypex 5 and an ApexDal. For each EAL, measurements were taken with the following products: 2% chlorhexidine solution (CHX-S group), 2% chlorhexidine gel (CHX-G group) and 2% NaOCl (NaOCl group). After performing an endodontic measurement, the endodontic instruments were stabilized with flow resin composite. Afterwards, the roots were removed from the alginate mass, and the apical one-third of each root was cut lengthways to recover the canal system. Last, the distance between the file tip and the apical foramen was measured under a microscope at 60 x magnification.ResultsStatistically significant differences were found between CHX-S and NaOCl and CHX-G and NaOCl, but no significant differences were detected between CHX-S and CHX-G during the testing of both devices. No statistically significant differences were observed between the Raypex 5 and ApexDal for all intracanal media tested.ConclusionThe EALs Raypex 5 and ApexDal had higher accuracy in the anatomical foramen of the root containing chlorhexidine in the gel or in the solution form than in the canal containing sodium hypochlorite.

Accuracy of Two Electronic Apex locators in Determining Simulated Root perforation (In Vitro Study)

“…In present study, the results showed that both EALs had no significant difference in detection of both perforations which is consistent with previous studies tested the same idea. Root ZX mini demonstrates consistent and accurate reading of root canal length and determination of apical constriction in presence of NaOCl and CHX (4,5,6,7,9,10,11,14,15,23,24) in addition the presence of 2% Chlorhexidine in the root canal did not affect the accuracy of both EALs used in this study.…”

“…Various electroconductive materials have been used such as agar-agar, alginate, gelatin, and a saline solution for in vitro evaluation of EALs in perforated teeth (6)(7)14) . In this study, alginate was selected as the embedding medium to simulate the periodontium because it is easy to handle, rigid, has firm consistency that prevent intrusion of the material into perforation, remains around the root, simulates the periodontal ligament with its colloidal consistency, and presents suitable electroconductivity (23). The rigid alginate firmly supported the teeth and permitted experiment to be performed with the roots embedded.…”

Uso de Localizadores Apicais: Revisão de Literatura / Use of Apical Locators: Literature Review

“…Nesse sentido, a determinação bem sucedida do comprimento de trabalho contribui com maior índice de sucesso do tratamento endodôntico (MAREK et al, 2020;SCARPARO, 2020;BOLAM et al, 2018). O método radiográfico é o mais utilizado na literatura para a obtenção de informações para determinar a odontometria (NÓBREGA et al, 2016;MAREK et al, 2020;SCARPARO, 2020;SILVA, 2018;VENANTE et al, 2017;EL SAMAN, 2016), porém, existe uma concordância entre pesquisadores que a técnica é limitada, apresentando desvantagens, como imagem bidimensional com estrutura tridimensional, imagem distorcida, sobreposição de estruturas anatômicas, exposição do paciente à radiação e induz a falhas de interpretação do operador (NÓBREGA et al, 2016;MAREK et al, 2020;SCARPARO, 2020;BOLAM et al, 2018;SILVA, 2018;EL SAMAN, 2016;VENANTE et al, 2017).…”

“…Quanto ao método eletrônico com o uso de localizadores apicais, a maioria dos dispositivos de medição eletrônicos são baseados na teoria de Suzuki et al (1942), que determinaram que a resistência elétrica entre a mucosa oral e os tecidos periodontais foi constante em 6,5 kΩ, independentemente da idade do paciente ou morfologia dentária (MAREK et al, 2020;SCARPARO, 2020;SILVA, 2018;EL SAMAN, 2016;VENANTE et al 2017). Foi a partir desta teoria que Sunada (1962), construiu o primeiro LAE, que demonstrou imprecisões nas leituras de eletrólitos ou tecidos pulpares vitais (MAREK et al, 2020), porém, ainda assim, a introdução destes mecanismos tem sido confiado com o papel fundamental na determinação do comprimento do canal radicular, mesmo diferindo dos originalmente propostos (OLIVEIRA et al, 2017).…”

“…Mais tarde, os dispositivos se tornaram mais sofisticados e usaram as características dos gradientes de impedância e dependência de frequência para fornecer medições mais precisas e confiáveis sob condições clínicas típicas (MAREK et al, 2020;OLIVEIRA et al, 2017). Os equipamentos evoluíram da primeira até a terceira gerações, tendo por fundamento o princípio físico da diferença de impedância no interior do canal radicular, definida através de diferentes sinais de frequência (NÓBREGA et al, 2016).…”