Confiabilidade das determinações de localizadores eletrônicos foraminais : estudos ex vivo e in vivo

Abstract

The electronic foramen locators (EFLs) currently available are based on different methods for determination of the distance between the apical foramen and a coronal reference, consequently presenting the real root canal length. Each of these methods aim to offer greater precision while presenting lower sensitivity to potential interferences found in the root canal system. With this in mind, the goal of this work was to evaluate the precision of some of these EFLs ex vivo and in vivo for electronic measurement of the root canal length at two different positions (0.0 mm and -1.0 mm) and under clinical conditions, respectively. In the ex vivo study, 42 mandibular bicuspids had their actual lengths compared to electronic measurements performed by the following EFLs: Root ZX, Mini Apex Locator, Propex II, iPex, and RomiApex A-15. Initial measurements were performed to positions identified by the devices as 1.0 mm short of the apical foramen (AF), and subsequent measurements were at the AF (0.0 mm). For the in vivo study, ten patients with bicuspids referred for extraction as part of their orthodontic clinical planning had electronic root length measurements using two EFLs, Propex II and Root ZX, prior to extraction. The last files used were fixated to the teeth, which were then extracted. Then, the apical 4 mm of the canals were exposed to allow assessment of the distance between the tip of the file and the AF. The percentages of precision from the ex vivo electronic measurements at 0.0 mm and -1.0 mm considering each device were: 70.6% and 47.1% (Root ZX); 61.8% and 52.9% (Mini Apex Locator); 67.6% and 38.2% (Propex II); 61.8% and 38.2% (iPex); and 73.5% and 38.2% (RomiApex A-15), respectively (±0.5 mm). Statistical differences were observed for Propex II, iPex, and RomiApex A-15 when measurements at both positions were compared (0.0 mm X -1.0 mm). No significant differences between the EFLs were observed at 0. 0 mm. However, at -1.0 mm, the precision of iPex was statistically lower compared with the other devices. Regarding the in vivo study, the AF was located in 75% (Root ZX) and 66.7% of the teeth (Propex II), under a tolerance margin of ±0.5 mm. Statistically significant differences were observed between the two EFLs. Based on the results obtained and considering the conditions of this work, it was concluded that EFLs are reliable tools for determining the real length of the canal, but are not infallible. It was also observed in the ex vivo experiments that all EFLs had decreased precision in measurements with the instruments short of the AF, with significant differences observed between Propex II, iPex, and RomiApex A-15. Moreover, it was concluded that under clinical conditions, Root ZX was more reliable than Propex II.