Evaluation of two electronic apex locator of 4th generation, Raypex4 and Apit7, in canal length deteermination

Determining correct working length in root canal therapy is of great importance in successful treatment. The purpose of this study was to compare the accuracy of two electronic apex locators of fourth generation, Raypex4 and Apit7, in determining working length in vivo. In this test evaluation study performed at Dental School of Tehran University, a total of 32 single canal vital teeth planned for extraction because of orthodontic and prosthetic reasons were selected. Working length determination by each of the two electronic apex locators was performed by two different dentists. These measurements were compared with direct visual measurement after tooth extraction. The dentists working with devices and the endodontist who determined the working length of the extracted teeth as well as the statistician, all were blind regarding the results. The data were compared using binominal distribution test with P<0.05 as the limit of significance. The accuracy of actual length determination of Raypex4 was 68.8% in the limit of +/- 0.5 and 83.3% in the limit of +/- 1. From the actual length measurements, 75.1% were within the tolerance of +0.5 to-1. The accuracy of the working length determination by Raypex4 was 68.8% within the tolerance of +/- 0.5 and 84.3% within the tolerance of +/- 1. Taking the tolerance of + 0.5 to -1 mm into account, the accuracy of the instrument was about 78.8%. The accuracy of actual length determination of Apit7 was 65.7% in the limit of +/- 0.5 and 78.3% in the limit of +/- 1. Compared to the visual length determination, 78.8% of the actual length measurements were within the tolerance of +0.5 to-1. The accuracy of the working length determination was 62.6% within the tolerance of +/- 0.5 and 81.3% within the tolerance of +/- 1. Taking the tolerance of + 0.5 to -1 mm into account, the accuracy of the instrument was about 75.1%. Conclusion: Raypex4 and Apit7 had similar accuracy in determining the actual length. However, they still can not replace the routine methods of actual length determination

[Evaluation of canal curvature preservation in molar teeth prepared at endodontic department of dental school, during a five years period [2000-2004]]

Preserving canal curvature during different phases of canal preparation is an important point. In Endodontic therapy all efforts are made to prepare canal in a way that final canal follows the primary canal curvature. The purpose of this study was to evaluate the efficacy of root canal preparation performed by students at Endodontic Department of Dental School, Tehran University of Medical Sciences. In this retrospective study, classic method of step- back technique was investigated for preserving canal curvature in mesial roots of first mandibular molars and mesiobuccal roots of first maxillary molars between years 2000 and 2004. A randomly selected sample of 400 dental patient records was investigated by 4 observers [Endodontic department professors], searching for procedural errors. A clear explanation sheet of curvature preservation and procedural errors such as ledge formation, apical foramen transportation, zipping and stripping and a questionnaire were prepared for observers. The observers went through reliability test and kappa value for agreement between every two observers. The results were above 0.8. Data were analyzed by EPI6 statistical computer program, using Chi-Square and Fisher exact test with P<0.05 as the limit of significance. This study consisted of 152 first maxillary molars and 248 first mandibular molars. The prevalence of curvature preservation in mesial root of first mandibular molars and mesiobuccal root of first maxillary molars were 38.5% and 47.6% respectively. Procedural errors detected consisted of 33% ledge formation, 26.1% apical foramen transportation, 1.8% zipping and 4.1% stripping for mesial root of the first mandibular molars. The results for the first maxillary molars were 27%, 19%, 3.2% and 3.2% respectively. The study results revealed the efficacy of endodontic education and the proficiency of junior and senior students in preparing curved posterior root canals. The results obtained in this retrospective study are comparable to prospective studies