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ABSTRACT Objective: To compare the accuracy of working length determination between cone beam computed tomography (CBCT) and electronic apex locator by measuring the actual working length of teeth. Material and Methods: A total of 150 single-rooted tooth assessed by radiograph undergoing root canal therapy were selected. The process was repeated to obtain a buccolingual and mesiodistal section of all teeth. The measurement line was considered from the reference occlusal plane following the center of the canal to the terminus. All information regarding the accuracy of cone-beam computed tomography and apex locator was noted in a pre-designed proforma. Results: CBCT consistently demonstrated high accuracy across all tooth types in both jaws. The electronic apex locator exhibited varying precision, with greater accuracy observed in the mandible. Statistical analyses revealed significant differences in electronic apex locator accuracy among tooth types in the maxilla (p=0.042), emphasizing the importance of specific clinical considerations. Conclusion: Cone beam computed tomography emerges as a reliable diagnostic tool for accurate working length determination, especially in complex cases, while the electronic apex locator remains valuable with careful consideration of potential variations in accuracy. An individualized approach, considering tooth type, jaw location, and clinical context, is crucial for precise working length determination in endodontic practice.

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ABSTRACT: The apical limit of tooth roots for instrumentation and obturation is a controversial subject due to the high morphological complexity presented by the apical zone of the root. The development of electronic apex locators (EALs) has made working length (WL) determination more predictable, producing more accurate results; however, the interpretation mechanisms of different devices may affect measurements taken under different clinical conditions. One hundred premolars were used to compare the effectiveness of Propex II, Raypex 6, Propex Pixi and Root ZX II in locating the apical foramen (AF). No statistically significant differences were observed when the accuracy of measurement was compared between the different groups of EALs, however Root ZX II and Raypex 6 presented the best overall performance.

RESUMEN: El límite apical radicular para la instrumentación y obturación es un tema controversial, debido a la alta complejidad morfológica que presenta la zona apical de la raíz. El desarrollo de localizadores de ápice electrónicos (EALs) ha hecho la determinación de la longitud de trabajo (WL) más predecible y con resultados más precisos. Sin embargo, el mecanismo de interpretación de cada dispositivo puede afectar la determinación de las mediciones en diferentes condiciones clínicas. Cien premolares fueron utilizados para comparar la efectividad de Propex II, Raypex 6, Propex Pixi y Root ZX II en localizar el foramen apical (AF). No se observaron diferencias estadísticamente significativas cuando se comparó la precisión de medición entre los diferentes grupos de EALs, sin embargo, Root ZX II y Raypex 6 mostraron un mejor desempeño global.

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Abstract Objective: To evaluate the reliability and validity of the Next Engine 3D Laser scanner. Material and Methods: A total of 30 dental casts of unilateral cleft lip and palate (UCLP) children with 90 linear variables were measured using digital caliper while the laser-scanned 3D dental casts (LS3DM) were measured using Mimics Software. All scanned data coordinates (in x, y, z) were transferred into Mimics software in STL format to be measured. All the variables were measured using a computer mouse accurate to 0.5 mm. The intra-class correlation coefficient (ICC) was used to evaluate the intra- and inter-examiner reliabilities and also for the validity of two methods Results: Intra-examiner reliabilities of digital caliper and LS3DM were found excellent (ICC 0.916-0.995) and inter-examiner reliabilities of LS3DM were good to excellent (ICC 0.816-0.990). The validity of LS3DM measurements was confirmed based on the ICC values were in the range of 0.913-0.996. The overall time frame for conducting measurements was shorter using a laser-scanned model (10 min.) than using a digital caliper (5 hours) Conclusion: The LS3DM is a valid reliable tool for future high impact research in our institution.

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El propósito de ese estudio fue evaluar in vivo la determinación de la longitud de trabajo utilizando el localizador apical electrónico Raypex 6. Material y métodos: Fueron determinadas la longitud de trabajo electrónica (Raypex 6) y radiográfica de 249 conductos radiculares de 125 pacientes con indicación de realizar tratamiento endodóntico. Los pacientes fueron atendidos según los protocolos clínicos habituales. La evaluación fue realizada en dos fases con dos niveles de aceptación, uno con una tolerancia de ± 0.5 mm y otra no. Resultados: En la fase 1 de nivel de tolerancia de evaluación, las mediciones fueron consideradas adecuadas (± 0.5 mm) en el 96.4 por ciento (93.3-98.3), cortos (- 0.5/1 mm) el 1.6 por ciento (04-4) y pasados (+ 0.5/1 mm) el 2 por ciento (0.7-4). Mientras que en la fase 2 de nivel de tolerancia de evaluación para las mediciones consideradas adecuadas (sin rango de tolerancia) fue de un 86.4 por ciento (81.5-91), cortos (- 0.5/1 mm) el 4 por ciento (2-7.8) y pasados (+ 0.5 y a 1 mm) el 9 por ciento (6-13.5). No fueron encontradas diferencias significativas al considerar eldiagnóstico y el género masculino o femenino. Conclusiones: Bajo lascondiciones en que se realizó este estudio la utilización del localizadorapical electrónico Raipex 6 ofreció una aceptable confiabilidad clínica en los dos niveles de tolerancia evaluados...

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Abstract The aim of this study was to evaluate in vivo the accuracy of the Raypex 5 and Root ZX electronic foramen locators (EFLs) in the presence of blood in the root canal space. Forty single-canal teeth scheduled for extraction were selected. Access cavity was prepared and coronal enlargement was carried out. Approximately two drops of blood were collected by finger prick and injected into the root canal space. The electronic working length (EWL) of each tooth by each device was established twice before (NB group) and after (WB group) injecting blood into the root canal. The tooth was extracted and the actual working length (AWL) was determined. Data were analyzed using McNemar's test. The accuracy rates of Raypex 5 and Root ZX within 0.5 mm in the NB group were 88.9% and 91.5%, with 83.3% and 86.2% in the WB group, respectively. There were no significant differences between the accuracy of each EFL in the two groups (p>0.05). Considering the NB and WB groups, there were no statistically significant differences in the accuracy of the EFLs (p>0.05). The presence of blood in the root canal space did not influence the accuracy of the EFLs.

Resumo Este estudo objetivou avaliar in vivo a precisão dos localizadores foraminais eletrônicos (EFLs) Raypex 5 e Root ZX em presença de sangue no canal radicular. Foram utilizados 40 dentes unirradiculares destinados a extração. Foi preparada cavidade de acesso e feita ampliação coronária. Cerca de duas gotas de sangue obtidas por punção digital foram injetadas no canal. O comprimento eletrônico de trabalho (EWL) foi medido duas vezes antes (Grupo NB) e depois (Grupo WB) da injeção do sangue. O dente foi extraído e o comprimento real de trabalho (AWL) foi determinado. Os dados foram analisados com o teste de McNemar. As taxas de precisão a ±0,5 mm de Raypex 5 e Root ZX foram 88,9% and 91,5% no Grupo NB, e 83,3% e 86,2% para o Grupo WB, respectivamente. Não houve diferença significativa entre a precisão de cada um dos EFLs em ambos os grupos (p>0,05). Considerando os grupos NB e WB, não houve diferença significativa entre as precisões dos EFLs (p>0,05). A presença de sangue no canal radicular não influencou a precisão dos EFLs.

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The aim of this study was to evaluate in vivo the accuracy of the Raypex 5 and Root ZX electronic foramen locators (EFLs) in the presence of blood in the root canal space. Forty single-canal teeth scheduled for extraction were selected. Access cavity was prepared and coronal enlargement was carried out. Approximately two drops of blood were collected by finger prick and injected into the root canal space. The electronic working length (EWL) of each tooth by each device was established twice before (NB group) and after (WB group) injecting blood into the root canal. The tooth was extracted and the actual working length (AWL) was determined. Data were analyzed using McNemar's test. The accuracy rates of Raypex 5 and Root ZX within 0.5 mm in the NB group were 88.9% and 91.5%, with 83.3% and 86.2% in the WB group, respectively. There were no significant differences between the accuracy of each EFL in the two groups (p>0.05). Considering the NB and WB groups, there were no statistically significant differences in the accuracy of the EFLs (p>0.05). The presence of blood in the root canal space did not influence the accuracy of the EFLs.

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AIM: To evaluate the potential for electromagnetic interference (EMI) of electronic apex locators (EALs) and a gutta-percha heating device (HD) in patients with implantable cardiac pacemakers (ICPs) or cardioverter-defibrillators (ICDs). METHODOLOGY: Two types of EALs (Romiapex A-15 and Novapex) and a HD (Touch'n Heat) were tested in patients followed in an outpatient clinic for cardiac arrhythmias. The heart rhythm was monitored on a computer screen during all experimental phases. After baseline data collection, the patient held each appliance (turned on) for 30 s, simulating their clinical use. If background noise was detected on the cardiac monitor, the sensitivity of the ICP/ICD was lowered by the cardiologist to evaluate the intensity of the detected EMI. RESULTS: Twelve patients were evaluated (5 female and 7 male), and in nine instances, background noise in their cardiac devices related to the use of the endodontic devices was detected (6 patients). After lowering the sensitivity of the cardiac implants, three patients had more severe EMI in six instances, including pauses in ICP function. The presence of a symptomatic or asymptomatic pause was related to the patient's underlying heart rhythm. The HD device produced background noise more often compared to EALs. These were associated with more severe types of EMI. CONCLUSION: The EALs and gutta-percha HD were capable of causing background noise detection or pauses in cardiac implants in vivo. The use of electronic dental devices nearby patients with cardiac implants should be carefully considered in clinical practice.

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Within the procedures involved in a successful endodontic treatment is the working length (WL) determination. The root canal end must be detected accurately, and a precise control of the WL must be maintained. There are several methods to determine WL. Researchers have published the average teeth length (ATL) to the human permanent dentition. These measurements are used as an anatomical reference. If the WL is evaluated using a radiographic image, it is accepted as clinical success if the limit of the canal sealing is 1 mm coronal to the root apex. One method to determine WL is based in substract 1 mm to ATL. Another method widely used, assert to achieve a more precise WL determination, through the use of an electronic apex locator (AL). Nevertheless, published measures of ATL are still used as anatomical reference, and are used to determine WL in the absence of an AL. The aim of this study was to determine the average WL of second molars and premolars with endodontic treatment indication using a PropexII® AL, and compare these measurements to WL determination using ATL method. A descriptive cross-sectional study with a non-random sample of consecutive cases was executed. Results showed that there were no statistically significant differences between the WL obtained with AL and ATL method in studied teeth, except mesio-buccal canal of second maxillary molars (19.94 mm average using AL, 1.54 mm greater than ATL method 18.40 mm; p= 0.002). The ATL method to determine WL could be used to determine the WL of second molars and premolars in studied population. Further research should be performed to determine if ATL method is safe and reliable to be used in absence of an AL or in patients where this instrument cannot be used.

Entre los procedimientos involucrados en un tratamiento endodóntico exitoso está la determinación de longitud de trabajo (LT). Esta debe mantenerse durante todo el tratamiento, y el extremo del canal radicular (CR) debe detectarse con precisión. Existen varios métodos para determinar LT; los investigadores han publicado la longitud total promedio (LTP) de la dentición permanente humana. Estas mediciones se utilizan como referencia anatómica. Si LT se evalúa usando una imagen radiográfica, se acepta como éxito clínico cuando el límite de la obturación radicular queda 1 mm coronal al ápice radicular. Un método para determinar LT se basa en restar 1 mm a la LTP. Otro método, que permite una determinación de LT más precisa, se realiza utilizando un localizador apical electrónico (LA). Pese a esto último, las medidas publicadas de LTP todavía se utilizan como referencia anatómica, para determinar LT en ausencia de un LA. El objetivo fue determinar LT promedio de los CR de segundos molares y premolares con indicación de endodoncia utilizando LA PropexII®, y comparar estas mediciones con la LT determinada utilizando el método de LTP. Se realizó un estudio descriptivo de corte transversal con una muestra no probabilística de casos consecutivos. No hubo diferencias estadísticamente significativas entre la LT obtenida con LA y el método LTP en los dientes estudiados, salvo en los canales mesio-bucales de segundos molares superiores (19,94mm promedio usando LA, 1,54 mm mayor que el método LTP: 18,40 mm; p= 0,002). El método para definir LT a través de LTP podría utilizarse para determinar LT de segundos molares y premolares en la población estudiada. Se requieren investigaciones posteriores para determinar si el método que utiliza LTP es confiable para ser utilizado en ausencia de un LA o en pacientes en los que este instrumento no pueda ocuparse.

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This study was to evaluate in vivo the accuracy of three electronic apex locators (EALs) in determining working length (WL) using hand files and a wear technique. Thirty two premolars that were completely formed apically and that were scheduled for extraction for orthodontic reasons from patients between ages of 15 and 20 years old were included. Electronic measurement of WL was performed using the EAL according to the manufacturer’s instructions. The following three EAL were used: A. Root ZX II; B. Raypex 5, and C. Propex II. There were significant difference (p=0.0002) when comparing median differences among the three EAL. Statistical analysis revealed significant differences between Root ZX II vs. Raypex 5 and Root ZX II vs. Propex II (p=0.0044; p=0.0002), while between aypex 5 and Propex II, there were no statistically significant differences with respect to the accuracy of the EAL in determining WL (p=0.1087). The present findings suggest that Root ZX II presented the highest agreement rate for determining the final WL...

Estudio fue evaluar in vivo la exactitud de tres localizadores apicales electrónicos(LAEs) para determinar la longitud de trabajo (LT) usando instrumentos manuales y una técnica de desgaste. Treinta y dos premolares con formación apical completa e indicados para extracción por razones ortodóncicas de pacientes de edad entre 15 y 20 años fueron incluidos en el estudio. Seusaron tres LAE; A. Root ZX II; B. Raypex 5, y C. Propex II. Se encontraron diferencias significativas (p=0.0002) cuando se compararon las medianas entre los tres LAE. El análisismostró diferencias entre Root ZX II vs. Raypex 5 y Root ZX II vs. Propex II (p=0.0044; p=0,0002), mientras queentre Raypex 5 y Propex II, no se encontraron diferencias estadísticamente significativas en la determinación de la LT (p=0.1087). Los presentes hallazgos sugieren que Root ZX II mostró la mayor exactitud para determinar la LT final...

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AIM: Difference in tooth size between deciduous and permanent teeth can resolve space problems during development of the dentition. AIM: To determine the difference in size between deciduous and permanent teeth in the anterior and posterior areas of the mouth in a group of school-age children from Medellin, Colombia. DESIGN: this longitudinal prospective, descriptive investigation was carried out in 139 skeletal Class I dental stone casts from school-age children from Medellin. Patients were followed annually from 6 to 12 years of age. The final sample consisted of 53 children (35 girls and 18 boys). Leeway space and the incisor liability were determined. RESULTS: A higher positive leeway space was found in the mandible than in the maxilla (3.622 mm and 1.556 mm, respectively). Incisor liability was negatively higher in the maxilla than in the mandible (-7.884mm and -5.386mm, respectively). Six patients showed a negative leeway space between -1.582 mm and -3.184 mm for the mandible and the maxilla, respectively. No statistical significant differences were found by gender; girls showed higher leeway space and incisor liability than boys. CONCLUSION: Normal values for one ethnic group should not be considered normal for another and each group must be treated according to its own characteristics.

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