Beruflich Dokumente
Kultur Dokumente
Key Words
Electronic apex locators, radiographic length measurement, root canal therapy
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Results
The results of length adequacy in each group for master cone and
final obturation are summarized in Tables 1 and 2, respectively. Reclassification of the outcome data by focusing on each subdivision results in
three cross-tabulations for the master cone and final obturation length
adequacy, each focusing on one of the three outcome categories: acceptable, over, and short. Based on these reclassified tables in the EAL group,
there was a higher percentage of acceptable cases, both for the master
cone as a primary outcome (c2, p = 0.09) and the final obturation
(c2, p = 0.32) as a secondary outcome than in the radiograph group,
but the difference was not statistically significant (p > 0.05). There
was a significantly lower percentage of overresults in the EAL group
compared with the radiographic group for master cone results (c2,
p = 0.00). There was also a lower but not statistically significant rate
of the over cases for the obturation results (c2, p = 0.32). There was
no statistically significant difference in the percentage of the short cases
for both the master cone (c2, p = 0.70) and the final obturation results
(c2, p = 0.87) between the two groups.
The average number of radiographs taken was 3 in the EAL group
and 4.07 in the radiographic group, which showed a highly significant
difference (Mann-Whitney U test, p = 0.00) . Vitality (c2, p = 0. 789)
and periapical lesions (c2, p = 0.504) were not associated with length
adequacy of the master cone as a primary outcome in the EAL group.
The Mann-Whitney U test revealed a borderline statistically significant difference in the amount of correction needed after taking master
cone radiography between the radiographic group (mean = 0.08 mm
and standard deviation = 0.5) and the EAL group (mean = 0.23 mm
and standard deviation = 0.5, p = 0.049). Also, reclassification of cases
based on doing or not doing correction after taking master cone radiography showed no statistical differences between the two groups (c2,
p = 0.80).
Discussion
Electronic methods for tooth length determination have progressed significantly and have been increasingly integrated into the
modern practice of endodontics (22). The accuracy of apex locators
has previously been investigated by several researchers. In some
in vitro studies, the simulation of the clinical situation has been
done by using electroconductive materials like alginate, gelatin, agar,
or saline (18, 23). Also, in some in vivo studies, after electronic
length measurement, the teeth were extracted, and different target
points like apical foramen, apical constriction, or radiographic apex
were compared with the point where a given electronic apex locator
has been shown as the terminus of root canal system (24, 25). None
of the previously mentioned studies can be a true representative of
clinical situations in which the whole treatment is done in the mouth.
This study, however, was a true simulation of what occurs during
a typical endodontic treatment. The end result was evaluated by radiography, which is an intrinsic problem associated with such kinds of
Short (%)
Acceptable (%)
Over (%)
6 (7.1)
9 (8.7)
69 (82.1)
94 (90.4)
9 (10.7)
1 (1.0)
Short (%)
Acceptable (%)
Over (%)
1 (1.2)
1 (1.0)
72 (85.7)
94 (90.4)
11 (13.1)
9 (8.7)
Conclusion
The results of endodontic treatment using electronic apex locator
are quite comparable if not superior to radiographic length measurement regarding the rates of acceptable and short cases. Furthermore,
in addition to reducing radiographic exposure, EALs can reduce the
rate of overestimation of root canal length.
Acknowledgments
The authors thank Dr Laaya Safi for her help with the evaluation of the radiographs, Dr Heydari for statistical assistance, and
Dr Faranak Rabiee for helping with the clinical tasks of this study.
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