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Apex locator consistency
HANDS ON Dental Devices Apex locator consistency Background.—The function of apex locators includes locating the apical foramen and identifying apical constriction, which is the ideal endpoint for root canal preparation and filling. Compared to radiographic methods, apex locators have an electronic working length (EWL) determination that is easier, faster, more accurate, and can be repeated indefinitely without radiation exposure. However, the greatest accuracy is obtained by combining the radiographic and EWL determinations. Apex locators have been studied for their accuracy and repeatability, but seldom for their consistency or regularity. Dysfunction frequency was determined and clinical conditions investigated for their effect on the performance of apex locators, focusing specifically on their consistency.
root canals were completely obliterated. Excluding these cases gave a consistency of the apex locators of 96%. Root ZX had a significantly higher consistency than Raypex5. Radiographic acceptability was noted for 97% of the root canals. None of the parameters measured influenced the radiographic position of the determined EWL. Metallic restorations may have affected unstable EWL measurements, but the type of restoration did not influence consistency overall.
Methods.—Five hundred seven patients who required endodontic therapy were subjected to EWL determinations. Among the clinical parameters recorded for each patient were tooth vitality, presence of obliteration, and metallic restoration. The Root ZX and Raypex5 apex locators were used. Consistency was assigned based on having the scale bars stable, moving only in correspondence with the movement of the file in the root canal. A working length radiograph was obtained in each case, with files set to the EWL. An acceptable result was defined as having the file tip located 0 to 2 mm short of the radiographic apex.
Clinical Significance.—The two apex locators functioned similarly, with 85% accuracy. Having an obliterated root canal or one with filling remnants caused inaccuracies. Isolating the tooth using a rubber dam and drying the pulp chamber adequately will help obtain stable EWL measurements when metallic restorations are present.
Results.—Eighty-five percent of the patients had consistent apex locator function. Inconsistent measurements were obtained when there were partially or completely obliterated root canals. Apex locators were always inconsistent when the
Discussion.—For one out of every six patients, only the radiographic working length could be determined. Apex locators were inconsistent when the root canal was obliterated or inaccessible.
ElAyouti A, Dima E, Ohmer J, et al: Consistency of apex locator function: A clinical study. J Endod 35:179-181, 2009 Reprints available from A ElAyouti, Dept of Conservative Dentistry and Endodontology, Univ of Tu¨bingen, Oslanderstraße 2-8, 72076 Tu¨bingen, Germany; e-mail: [email protected]
Dental Diagnosis Diagnosing root fractures in children Background.—Root fractures in the permanent dentition of children are more likely to occur between ages 11 and 20 years. They involve the maxillary central incisors in 75% of cases. A frontal impact that creates compression zones labially and lingually is usually the causative
178
Dental Abstracts
mechanism. The clinical appearance is a slightly extruded tooth that is frequently displaced lingually and usually mobile. Diagnosis depends on radiographic information gained by directing the radiographic beam through the plane of fracture. In particular, radiographs will differentiate root
root canals were completely obliterated. Excluding these cases gave a consistency of the apex locators of 96%. Root ZX had a significantly higher consistency than Raypex5. Radiographic acceptability was noted for 97% of the root canals. None of the parameters measured influenced the radiographic position of the determined EWL. Metallic restorations may have affected unstable EWL measurements, but the type of restoration did not influence consistency overall.
Methods.—Five hundred seven patients who required endodontic therapy were subjected to EWL determinations. Among the clinical parameters recorded for each patient were tooth vitality, presence of obliteration, and metallic restoration. The Root ZX and Raypex5 apex locators were used. Consistency was assigned based on having the scale bars stable, moving only in correspondence with the movement of the file in the root canal. A working length radiograph was obtained in each case, with files set to the EWL. An acceptable result was defined as having the file tip located 0 to 2 mm short of the radiographic apex.
Clinical Significance.—The two apex locators functioned similarly, with 85% accuracy. Having an obliterated root canal or one with filling remnants caused inaccuracies. Isolating the tooth using a rubber dam and drying the pulp chamber adequately will help obtain stable EWL measurements when metallic restorations are present.
Results.—Eighty-five percent of the patients had consistent apex locator function. Inconsistent measurements were obtained when there were partially or completely obliterated root canals. Apex locators were always inconsistent when the
Discussion.—For one out of every six patients, only the radiographic working length could be determined. Apex locators were inconsistent when the root canal was obliterated or inaccessible.
ElAyouti A, Dima E, Ohmer J, et al: Consistency of apex locator function: A clinical study. J Endod 35:179-181, 2009 Reprints available from A ElAyouti, Dept of Conservative Dentistry and Endodontology, Univ of Tu¨bingen, Oslanderstraße 2-8, 72076 Tu¨bingen, Germany; e-mail: [email protected]
Dental Diagnosis Diagnosing root fractures in children Background.—Root fractures in the permanent dentition of children are more likely to occur between ages 11 and 20 years. They involve the maxillary central incisors in 75% of cases. A frontal impact that creates compression zones labially and lingually is usually the causative
178
Dental Abstracts
mechanism. The clinical appearance is a slightly extruded tooth that is frequently displaced lingually and usually mobile. Diagnosis depends on radiographic information gained by directing the radiographic beam through the plane of fracture. In particular, radiographs will differentiate root