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The influence of periapical lesions on the repeatability of two electronic apex locators in vivo

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Abstract

Objectives

To determine the influence of periapical lesions on the repeatability of two electronic apex locators (EALs), Root ZX II, and RomiApex A-15, in maxillary anterior teeth, in vivo.

Materials and methods

After approval by the local ethics committee, 43 maxillary anterior teeth scheduled for root canal therapy were assigned to two groups. The periapical lesion (PAL) group included 21 teeth with necrotic pulps and radiographically visible periapical lesion, and the normal periapex (NPA) group consisted of 22 teeth with vital pulps and no periapical lesion. In each canal, Root ZX II and RomiApex A-15 were used to determine working length defined as the “zero” reading on the display. Two consecutive measurements were performed with each EAL on each tooth and a second operator measured the endodontic file with a digital caliper without knowledge of the EAL being used or the tooth diagnosis. The absolute value of the difference between the first and second measurement (measurement pairs) was calculated. Repeatability was evaluated by the Bland-Altman method, and an aligned ranks transformation ANOVA was conducted to compare the EALs.

Results

The median absolute difference between measurement pairs was significantly lower (p < 0.001) and the limits of agreement were narrower in the NPA group. Among the EALs, median absolute differences were significantly smaller for Root ZX (p < 0.001).

Conclusions

Measurements were more repeatable when no periapical lesion was present. Root ZX showed better repeatability than RomiApex.

Clinical relevance

Periapical lesions seem to influence successive in vivo measurements with EALs.

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Acknowledgment

Supported by a research grant awarded by the Directorate-General for Scientific and Technological Research of the National University of Asuncion. The authors deny any conflicts of interest.

Funding

Supported by a research grant awarded by the Directorate-General for Scientific and Technological Research of the National University of Asuncion, Asunción, Paraguay.

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Authors and Affiliations

  1. Universidad Nacional de Asunción, Facultad de Odontología, Asunción, Paraguay

    Carlos G. Adorno, Sandra M. Solaeche, Ileana E. Ferreira, Andrea Pedrozo & Vicente R. Fretes

  2. Endodontics Department, Instituto ECO, Asunción, Paraguay

    Patricia M. Escobar

Authors
  1. Carlos G. Adorno
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  2. Sandra M. Solaeche
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  3. Ileana E. Ferreira
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  4. Andrea Pedrozo
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  6. Vicente R. Fretes
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Contributions

Conceptualization: Carlos G. Adorno, Vicente R. Fretes

Methodology: Carlos G. Adorno, Patricia M. Escobar, Vicente R. Fretes

Investigation: Sandra M. Solaeche, Ileana E. Ferreira, Andrea Pedrozo

Formal analysis: Carlos G. Adorno

Writing—original draft preparation: Carlos G. Adorno

Writing—review and editing: Carlos G. Adorno, Sandra M. Solaeche, Ileana E. Ferreira, Andrea Pedrozo, Patricia M. Escobar, Vicente R. Fretes

Funding acquisition: Vicente R. Fretes, Carlos G. Adorno

Resources: Andrea Pedrozo, Sandra M. Solaeche, Ileana E. Ferreira

Supervision: Vicente R. Fretes, Patricia M. Escobar

Corresponding author

Correspondence to Carlos G. Adorno.

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Adorno, C.G., Solaeche, S.M., Ferreira, I.E. et al. The influence of periapical lesions on the repeatability of two electronic apex locators in vivo. Clin Oral Invest 25, 5239–5245 (2021). https://doi.org/10.1007/s00784-021-03831-w

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