scholarly journals Apical reference point - A clinical perspective

2021 ◽  
Vol 7 ◽  
pp. 2-5
Author(s):  
Samyuktha Sivakumar ◽  
Boopathi Thangavel ◽  
Manimaran Sekar

The clinicians face various challenges in trying to find the optimum working length during root canal treatment. Unless proper biomechanical preparation up to the apical limit is done, reinfection of the canal occurs. Apical reference point must be measured with at most care as to avoid any damage to the surrounding periodontal tissues during the treatment.

Author(s):  
Swati Manhas ◽  
Sonia Lakra ◽  
Mehak ◽  
Abhishek Sharma ◽  
Kriti Garg ◽  
...  

Successful root canal treatment depends on thorough cleaning & shaping and 3- dimensional fluid impervious obturation of tooth within the confines of canals. To achieve this objective  the apical constriction must be detected accurately during canal preparation and precise  control over  working length  during the  procedure must  be maintained.  There are  many methods  of working length determination including  radigraphs  and electronic method(apex locator). Introduction of apex locators  have definitely served  as an effective adjuvant  to radiographs. 


2021 ◽  
Vol 10 (8) ◽  
pp. e39710817416
Author(s):  
Geraldo Fernando Stroparo ◽  
Jeferson Luis De Oliveira Stroparo ◽  
Paula de Moura ◽  
Tatiana Miranda Deliberador ◽  
Allan Abuabara ◽  
...  

Teeth with extraordinary length are a rare condition that complicates endodontic procedures due to the difficult in being reached the working length and making the adequate preparation of the root canal, once there are no endodontic instruments longer than 31 mm commercially available. This study presents a description of technical adaptations for endodontic preparation of a maxillary canine with 39.59 mm of length. The procedures adopted were based on the consultation of the literature regarding the treatment of long teeth, and included endodontic instrument adaptation and changing the reference point of the instrument. This study shows that extremely long teeth can be successfully instrumented endodontically using the described clinical techniques.


2018 ◽  
Vol 43 (3) ◽  
pp. 120-125
Author(s):  
AKM Bashar ◽  
Tanzila Rafique ◽  
Ranjit Ghosh ◽  
Kamal Abdullah ◽  
Mohmood Sajedeen ◽  
...  

Obtaining a correct working length is critical to success of endodontic therapy. The procedure for establishment of working length should be performed using techniques that have been proven to give valuable and accurate results and methods that are practical and efficacious. The development of the electronic apex locator has helped to assess the working length more accurate and predictable. So the objective of this in vivo-ex vivo study was to evaluate the clinical accuracy of electronic apex locator in measuring the working length of the root canal in vivo, and comparing the lengths so measured, to the actual working length, ex vivo and after extraction. Electronic apex locator C-Root-I VI (Foshan COXO Medical Instrument Co. China) was used to measure the working length in 100 root canals (one palatal canal and one buccal canal in fifty maxillary 1st premolar) in vivo before extraction, that were scheduled for orthodontic treatment in twenty-five patients. Teeth were then extracted and apical constrictions were identified by careful preparation of the apical 4 mm of all the roots. Actual working lengths were determined by adjusting an endodontic file in the root canal upto the constriction from the coronal reference point. Electronic working lengths obtained in vivo were then compared for coincidence with the actual lengths thus measured after extraction (ex vivo). The data were statistically analysed by a paired Student 't' test and Pearson correlation-coefficient test. In 14 canals out of 100 electronic working lengths (EWL) truly coincided with actual working length (AWL). Eighty two canals out of 100, EWLs were <0.5 mm short in measurement than AWLs but the difference with AWL was statistically insignificant (p >0.01). Only in 4 canals (4%) EWLs were either >0.5mm short or more than AWL, thereby fail to meet the criteria of acceptable range of coincidence (⩽0.5 mm from the apical constriction). On reliability analysis, all (100%) electronic working length significantly correlate with the actual working length (r=0.971). Within a clinically acceptable range of ⩽0.5 mm, C Root I apex locator device showed a high degree of success (96%) in determination of working length during root canal treatment.


2019 ◽  
Vol 30 (6) ◽  
pp. 550-554
Author(s):  
Norberto J Broon ◽  
Claudia Azucena Palafox-Sánchez ◽  
Carlos Estrela ◽  
Diana Celeste Salazar Camarena ◽  
Mario Uribe ◽  
...  

Abstract Electronic apex locators (EAL) have been used to establish the working length (WL) in root canal treatment. In teeth diagnosed with apical periodontitis, resorption of tooth apical structures can lead to difficulties to obtain an appropriate WL. The aim was to compare the capacity of three EAL’s (Root ZX II, Raypex 6 and Endo-Eze Quill) to locate the tip of the K-file between 0 to -0.5 mm from the apical foramen (AF) on teeth diagnosed with asymptomatic apical periodontitis (AAP). Electronic working length was performed on 60 roots with AAP. A K-file #15 was inserted in the root canal until the apical foramen (AF) was located, and followed was re-adjusted to -0.5 mm through observation in EAL display. The K-file was fixed to the tooth with composite and teeth were extracted. The 4 apical millimeters were worn out until the K-file could be seen and were prepared and measured its distance to AF in a scanning electron microscope. Appropriate WL was when the tip of the K-file was located between 0 to -0.5 mm from AF. Results: Root ZX II showed significant difference (p<0.01) with the other two EALs. Root ZX II presented the better performance than Raypex 6 or Endo-Eze Quill in teeth with AAP.


2021 ◽  
Vol 6 (2) ◽  
pp. 85-87
Author(s):  
Alvi Fatima ◽  
Hares Shabir ◽  
Arushi Goyal ◽  
Akshun S Gupta ◽  
Faiz Khan ◽  
...  

The most important step in the success of the root canal treatment is the proper cleaning and shaping of the canal system. Cleaning and shaping means the removal of the entire pulpal tissue from the canal, so that there will be no residue left of any vital structure, that may cause any painful or infectious condition for the future. Some times there occurs difficulty in cleaning as well as shaping of the root canal in the posterior tooth or teeth, where the anatomy of the root is some what curved, and there occur difficulty in removing the vital tissue along with difficulty in achieving the accurate working length of the tooth. In this type of situation use of nickel titanium single file system is quite beneficial.


2004 ◽  
Vol 12 (1) ◽  
pp. 89-92 ◽  
Author(s):  
Mario Roberto Leonardo ◽  
Devanir de Araújo Cervi ◽  
Juliane Maria Guerreiro Tanomaru ◽  
Léa Assed Bezerra da Silva

The aim of this study was to evaluate apical sealing after root canal treatment using two different rotary instrumentation techniques and two thermoplastic root canal filling techniques. The study was performed in 115 human extracted mandibular premolars. After coronary access the apical foramen was opened with a # 15 K file 1 mm beyond the apex. Cleaning and shaping was subsequently carried out at the working length, 1 mm from the apex, with ProFile .04/.06 system (Dentsply/Maillefer), Quantec (Analytic Endodontics/Kerr) or by the step-back technique with 1% sodium hypochlorite solution as irrigating solution. The root canals were filled with Thermafil (Dentsply/Maillefer) or Microseal (Analytic Endodontics/Kerr) or by lateral condensation technique using AH Plus sealer (epoxy type). The teeth were immersed in 2% methylene blue under vacuum. Then, they were longitudinally sectioned. The results showed that the association of Profile and Thermafil Plus provide the best results (p<0.05). In conclusion, the association of different rotary instrumentation techniques and different filling systems influenced the apical sealing.


2020 ◽  
Vol 24 (1) ◽  
pp. 49-52
Author(s):  
Ioannis Molyvdas ◽  
Anna Digka ◽  
Georgios Mikrogeorgis

SummaryBackground/Aim: The aim of root canal treatment is the thorough cleaning, shaping and obturation of the root canals. Variations in root canal anatomy increase the difficulty of the root canal treatment and therefore the possibility of failure. The mandibular premolars often present complex anatomy and the existence of mandibular second premolars with three root canals is very scarce. This report presents the successful endodontic management of four mandibular second premolars with three root canals.Cases Report: In all cases working length was estimated using the working length radiograph and an apex locator. Canal orifices were enlarged with Gates-Glidden drills and manual instrumentation performed with Stainless Steel reamers and Hedstroem files, using either step-back or crown-down technique. Sodium hypochlorite (NaOCl) 2.5% was used as an irrigant. Root canal obturation were then performed using the cold lateral condensation technique with gutta-percha points and Roth’s 801 canal sealer. The cases were scheduled for clinical and radiographic follow-up examination. Clinically in all follow-up examinations the teeth were asymptomatic. For the three cases with periapical lesions, post treatment radiographs, demonstrated periapical healing. Additionally, in the case without periapical lesion, the 9 months recall radiograph revealed healthy periapical conditions.Conclusions: Mandibular premolars should never be underestimated and the clinician should always be alerted for anatomic variations.


2016 ◽  
Vol 8 (2) ◽  
pp. 4-4
Author(s):  
Sanam Mirbeygi ◽  
Maryam Kazemipoor ◽  
Sahar Ghane ◽  
Simin Shafiei

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