Comparative Accuracy and Reliability of Three Electronic Apex Locators in Determining the Apical Constriction of Molar Canals: A Micro-CT Evaluation

Author:

Barakat Reem M.1ORCID,Almohareb Rahaf A.2ORCID,Alharbi Arwa O.3ORCID,Alhazmi Asma3,Alomar Reem3ORCID

Affiliation:

1. Dental Clinics Department, King Abdullah bin Abdulaziz University Hospital, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia

2. Department of Clinical Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 11671, Saudi Arabia

3. Dental Intern, College of Dentistry, Princess Nourah Bint Abdulrahman University, P.O. Box 84428, Riyadh 1167, Saudi Arabia

Abstract

Background: Determining the correct apical limit for root canal treatment is essential for its success. This study evaluates the accuracy of three electronic apex locators (EALs) in locating the apical constriction (AC) in molar canals. Methods: Forty extracted human mandibular molars were scanned using micro-CT, and endodontic access cavities were created. Teeth were mounted in alginate, and three EALs—Root ZX-mini, Root ZX-II, and Sirona integrated apex locator—were used to measure the canal working length in dry canals and with EDTA gel. Micro-CT scans were performed with files in place, and the distance from the AC was calculated. Measurements within 0.1–0.5 mm were categorized as ‘close’. Those extending beyond towards the major foramen were categorized as ‘beyond’, otherwise they were classified as ‘far’. Data analysis was conducted with a level of significance set at 5%. Results: Most readings for all EALs were in the ‘close’ category, with significant differences between devices (p < 0.0001). Root ZX-mini and Root ZX-II had 74.4% and 72.5% ‘close’ readings, respectively, versus 51% for Sirona integrated. Accuracy did not differ significantly between dry and EDTA-treated canals (p = 0.306). All EALs demonstrated excellent operator reliability (ICC 0.996–1.00). Conclusions: All EALs accurately determined AC, unaffected by lubricants. However, Root ZX-mini and Root ZX-II outperformed Sirona integrated. All EALs showed consistent reliability.

Funder

Princess Nourah bint Abdulrahman University

Publisher

MDPI AG

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