ABSTRACT
The success of an endodontic treatment relies on a correct working length determination. The canal terminus must be detected accurately and a precise control of the working length during the endodontic treatment must be maintained. The aim of this study was to investigate the working length determination in vivo with the Quill Apex Locator® for apical limit established at 1 mm short from the apical foramen (AF). Patients scheduled to dental extraction due to orthodontic or periodontal reasons were selected for this study, resulting in a sample of 24 root canals. Written informed consent was obtained from each patient before the treatment. After the administration of local anesthesia each tooth had its pulp cavity accessed. Next, the reading corresponding to the AF showed on the device's display was recorded and the file was removed. With the use of a digital caliper, 1 mm was subtracted from that first measurement. The file with the new measurement was introduced into to the root canal again then fixed with light curing flow composite and the tooth was extracted. Next, one of the apical third walls was worn out to visualize the instrument's point and the AF. The distance from the file tip to the AF was measured by scanning electron microscopy. The average of the measurements was 1.089±0.437 mm. The Bicaudal t-test showed no significant difference (p=0.338) between the experimental values and the hypothetical value tested at 1 mm. The present investigation confirmed that the Quill Apex Locator® was able to determine the working length with good reliability for the endodontic treatment, established at 1 mm short from the AF.
Subject(s)
Tooth Apex/anatomy & histology , Endodontics , Humans , Microscopy, Electron, ScanningABSTRACT
The success of an endodontic treatment relies on a correct working length determination. The canal terminus must be detected accurately and a precise control of the working length during the endodontic treatment must be maintained. The aim of this study was to investigate the working length determination in vivo with the Quill Apex Locator® for apical limit established at 1 mm short from the apical foramen (AF). Patients scheduled to dental extraction due to orthodontic or periodontal reasons were selected for this study, resulting in a sample of 24 root canals. Written informed consent was obtained from each patient before the treatment. After the administration of local anesthesia each tooth had its pulp cavity accessed. Next, the reading corresponding to the AF showed on the device's display was recorded and the file was removed. With the use of a digital caliper, 1 mm was subtracted from that first measurement. The file with the new measurement was introduced into to the root canal again then fixed with light curing flow composite and the tooth was extracted. Next, one of the apical third walls was worn out to visualize the instrument's point and the AF. The distance from the file tip to the AF was measured by scanning electron microscopy. The average of the measurements was 1.089±0.437 mm. The Bicaudal t-test showed no significant difference (p=0.338) between the experimental values and the hypothetical value tested at 1 mm. The present investigation confirmed that the Quill Apex Locator® was able to determine the working length with good reliability for the endodontic treatment, established at 1 mm short from the AF.
O sucesso do tratamento endodôntico depende da correta determinação do comprimento de trabalho. O término do canal deve ser detectado com precisão e o controle do comprimento de trabalho durante o tratamento deve ser mantido. A proposta dessa investigação foi avaliar a capacidade do localizador foraminal Quill® determinar o comprimento de trabalho, a partir da localização do forame apical, estabelecido no presente estudo em 1 mm aquém do forame apical. Pacientes com indicação para extração dental por motivos ortodônticos ou periodontais foram selecionados, resultando em uma amostra de 24 canais. O termo de consentimento livre e esclarecido foi obtido de cada paciente antes dos tratamentos. Após a administração de anestesia local, a cavidade pulpar foi acessada. Em sequência, as leituras correspondentes ao forame apical mostradas no display do aparelho foram registradas e a lima removida. Com o uso de paquímetro digital, 1 mm foi subtraído da primeira medida. A lima com a nova medida foi introduzida no canal radicular novamente, fixada com resina flow e então o dente foi extraído. Após, uma das paredes do terço apical foi desgastada para vizualização da ponta do instrumento e forame apical. A distância da ponta da lima ao forame apical foi mensurada no MEV. A média das medidas foi de 1,089mm (±0,437mm). O teste t Bicaudal mostrou não haver diferenças significantes (p=0,338) entre os valores experimentais e um valor hipotético testado de 1 mm. O localizador foraminal Quill® foi capaz de determinar um satisfatório comprimento de trabalho para o tratamento endodôntico, estabelecido em 1 mm aquém do forame apical.
Subject(s)
Humans , Tooth Apex/anatomy & histology , Endodontics , Microscopy, Electron, ScanningABSTRACT
Objetivo: Avaliar a precisão e confiabilidade de dois modelos de localizadores apicais de fabricação chinesa (Joypex 5 e Root SW), comparados ao aparelho Root ZX II. Método: Quinze pré-molares superiores e inferiores uni e multirradiculares obtidos no banco de dentes da Universidade Federal de Mato Grosso do Sul, foram utilizados na pesquisa. Após a seleção dos dentes e preparo prévio dos terços cervical e médio dos canais radiculares com brocas de Gates Glidden 2, 3 e 4, foi realizada a medida do comprimento real do dente introduzindo uma lima K#15 dentro do canal e observando a saída da ponta do instrumento no forame maior utilizando um microscópio odontológico no aumento de 20X com iluminação média para melhor visualização. Para realização das medidas eletrônicas um modelo experimental foi confeccionado de maneira que o terço cervical das raízes ficassem fixadas no recipiente plástico e os terços médio e apical dos espécimes ficassem mergulhados em solução de soro fisiológico a 0,9%. Os aparelhos Root ZX II, Joypex 5 e Root SW foram utilizados para determinação do comprimento de trabalho eletrônico e as medidas foram comparadas. Foram utilizadods os testes estatísticos de Kruskal-Wallis e de Dunn's. Resultados: Os três aparelhos provaram ser eficientes, não existindo nenhuma diferença estatística significante (P< 0,05). Conclusão: Os localizadores Root ZX II e os novos aparelhos de fabricação chinesa Joypex 5 e Root SW mostraram-se precisos e confiáveis na determinação de um comprimento de trabalho aceitável para o tratamento endodôntico.
Objective: To evaluate the accuracy and reliability of two models of apex locators made in China (Joypex 5 and Root SW) compared to the Root ZX II equipment. Method: Fifteen single-rooted and multi -rooted maxillary and mandibular premolars obtained from the tooth bank of the Federal University of Mato Grosso do Sul were used in the study. After selection of the teeth, the cervical and middle thirds of the root canals were preflared with Gates Glidden drills #2, 3 and 4. Them, the real tooth length was determined by introducing a #15 K-file into the canals until its tip was seen exiting the larger foramen with the aid of a dental microscope at 20 magnification under moderate illumination to improve visualization. For the electronic working length determination with Root ZX II, Joypex 5 and Root SW apex locators, an experimental model was prepared in such a way that the cervical third of the roots were fixed in a plastic receptacle and the middle and apical thirds of the specimens remained immersed in saline. The obtained electronic measurements were compared to each other. Kruskal-Wallis and Dunn's tests were used for statistical analysis. Results: The three apex locators were equally efficient, with no statistically significant differences among them (p<0.05). Conclusion: Root ZX II and the two new models of apex locators made in China (Joypex 5 and Root SW) were proven accurate and reliable for providing an acceptable electronic working length determination for the endodontic treatment.
