Dilara ARSLAN, Demet ALTUNBAŞ, Alper KUŞTARCI

Farklı Seviyelerde Yapay Olarak Oluşturulmuş Horizontal Kök Kırıklarının Tespitinde İki Apeks Bulucunun Doğruluğunun Karşılaştırılması

Amaç: Bu çalışmanın amacı yapay olarak oluşturulan horizontal kök kırıklarının teşhisinde iki farklı elektronik apeks bulucu cihazın (Dentaport ZX and Rootor) etkinliğinin karşılaştırılmasıdır. Gereç ve Yöntem: 40 adet tek köklü çekilmiş daimi diş her bir grupta 20 adet olmak üzere 2 guruba ayrıldı. 0.25 mm kalınlığında elmas separe kullanılarak köklerin orta ve apikal üçlü hizasında horizontal kırık hatları oluşturuldu. Aljinat model içine yerleştirilen kökler üzerinde her iki apeks bulucu ile horizontal kırık hatlarının tespiti 10 K eğesi kullanılarak yapıldı. Gerçek ölçümler aynı eğe kullanılarak stereomikroskop (SMZ 800, Nikon, Tokyo, Japan) kullanılarak tespit edildi. Gerçek ve elektronik ölçümler arasındaki fark hesaplandı. İstatistiksel incelemelerde Mann-Whitney U ve Wilcoxon Eşleştirilmiş İki Örnek Testi testleri kullanıldı. Bulgular: Dentaport ZX ve Rootor apeks bulucuların orta ve apikal horizontal kırık seviyelerinde elektronik ve gerçek ölçümlerin farklarının ortalamaları sırası ile -0.12 ± 0.27; 0.09 ± 0.38; -0.10 ± 0.25; 0.18 ± 0.53 mm’dir. Dentaport ZX orta horizontal kırık seviyesinde 18 örnekte ve apikal horizontal kırık seviyesinde 19 örnekte, Rootor ise orta horizontal kırık seviyesinde 12 örnekte ve apikal horizontal kırık seviyesinde 11 örnekte gerçek ölçümlere kıyasla ±0,5 mm içerisinde tespitler yapmıştır. Her iki kırık seviyesinde Dentaport ZX ile Rootor’a ait ölçüm değerleri arasındaki farklılık istatistiksel olarak önemli bulunmuştur (p.05). Sonuç: Dentaport ZX ile yapılan ölçümler gerçek ölçümlerden daha kısa tespit edilirken, Rootor ölçümleri daha uzun tespit edilmiştir. Ayrıca ±0.5 mm içerisinde elde edilen ölçüm sayısı Dentaport ZX’de Rootora göre daha fazladır. Bu koşullar altında; Dentaport ZX ile yapılan ölçümlerin daha kabul edilebilir olduğunu söyleyebiliriz.

Effectiveness of Two Apex Locators to Determine Simulated Horizontal Root Fractures

Aim: The aim of this study was to evaluate in vitro the effectiveness of the two different electronic apex locators (Dentaport ZX and Rootor-EALs) in locating simulated horizontalroot fractures.Materials and Methods: Forty extracted human single-rooted teeth with mature apices were randomly divided into twogroups of 20 teeth each. An incomplete horizontal fracturewas simulated by preparing a with a 0.25 mm thick disk inthe middle and apical portion of the root and the teeth weremounted in an alginate mold. The electronic measurements(ELs) of the simulated root fractures were established with asize 10 K-file by each EAL in both fracture levels. The actualcanal lenghts (ALs) were measured under a stereomicroscope. The ALs were subtracted from the ELs of the fractures.The data were analyzed using the Mann-Whitney U and theWilcoxon signed-rank tests at a significance level of P < .05.Results: The mean differences between the ELs and ALswere -0.12 ± 0.27; 0.09 ± 0.38; -0.10 ± 0.25; 0.18 ± 0.53 mmin the Dentaport ZX and Rootor groups and middle and apical horizontal fracture levels, respectively. The Dentaport ZXperformed measurements within ±0.5 mm in 18 and in 19samples while the Rootor performed in 12 and in 11 samples,middle and apical horizontal fracture levels respectively. Statistically, significant differences were found among the EALsat both horizontal fracture levels (P < .05). However; no statistically significant differences were found between the fracturelevels in each of the EALs (P > .05).Conclusions: The Dentaport ZX measurements were shorter than ALs whereas the Rootor measurements were longerthan Als. Furthermore, the number of measurements obtainedwithin ± 0.5 mm in Dentaport ZX is more than that of Rootor.Under the conditions of this study, the Dentaport ZX groupshowed an acceptable determination of the horizontal rootfracture.

PDF

___

Topuz O, Uzun O, Tinaz AC, Bodrumlu E, Gorgul G. Accuracy of two apex-locating handpieces in detecting simulated vertical and horizontal root fractures. J Endod 2008; 34: 310-313.
Lindhal B. Transverse intraalveolar root fractures: roentgen diagnosis and prognosis. Odont Revy 1958; 9: 10-24.
Goldberg F, Frajlich S, Kuttler S, Manzur E, Briseno-Marroquin B. The evaluation of four electronic apex locators in teeth with simulated horizontal oblique root fractures. J Endod 2008; 34: 1497-1499.
Pallares A, Faus V. An in vivo comparative study of two apex locators. J Endod 1994; 20: 576-579.
Fuss Z, Assooline LS, Kaufman AY. Determination of location of root perforations by electronic apex locators. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996; 82: 324-329.
Gordon MP, Chandler NP. Electronic apex locators. Int Endod J 2004; 37: 425-437.
Suzuki K. Experimental study on iontophoresis. J Jpn Stomatol 1942; 16: 411-429. 8.Sunada I. New method for measuring the lenght of the root canal. J Dent Res 1962; 41: 375-387.
Ebrahim AK, Wadachi R, Suda H. Accuracy of three different electronic apex locators in detecting simulated horizontal and vertical root fractures. Aust Endod J 2006; 32: 64-69.
Nahmias Y, Aurelio JA, Gerstein H. Expanded use of the electronic canal length measuring devices. J Endod 1983; 9: 347-349.
Cimilli H, Aydemir S, Arican B, Mumcu G, Chandler N, Kartal N. Accuracy of the Dentaport ZX apex locator for working length determination when retreating molar root canals. Aust Endod J 2014; 40: 2-5.
Kustarci A, Arslan D, Altunbas D. In vitro comparison of working length determination using three different electronic apex locators. Dent Res J 2014; 11: 568-573.
Pascon EA, Marrelli M, Congi O, Ciancio R, Miceli F, Versiani MA. An in vivo comparison of working length determination of two frequency-based electronic apex locators. Int Endod J 2009; 42: 1026-1031.
Altunbas D, Kustarci A, Toyoglu M. The Influence of Various Irrigants on the Accuracy of 2 Electronic Apex Locators in Locating Simulated Root Perforations. J Endod 2017; 43: 439-442
Altunbas D, Kustarci A, Arslan D, Er K, Kocak S. Comparison of various current electronic apex locators to determine the working length using the clearing technique. Niger J Clin Pract 2015; 18: 359-363.
Cvek M, Mejare I, Andreasen JO. Conservative endodontic treatment of teeth fractured in the middle or apical part of the root. Dent Traumatol 2004; 20: 261-269.
Baldi JV, Victorino FR, Bernardes RA, de Moraes IG, Bramante CM, Garcia RB, et al. Influence of embedding media on the assessment of electronic apex locators. J Endod 2007; 33: 476-479.
Czerw RJ, Fulkerson MS, Donnelly JC. An in vitro test of a simplified model to demonstrate the operation of electronic root canal measuring devices. J Endod 1994; 20: 605-606. 19.Ushiyama J. New principle and method for measuring the root canal length. J Endod 1983; 9: 97-104.
Azabal M, Garcia-Otero D, de la Macorra JC. Accuracy of the Justy II Apex locator in determining working length in simulated horizontal and vertical fractures. Int Endod J 2004; 37: 174-177.
al Kadi H, Sykes LM, Vally Z. Accuracy of the Raypex-4 and Propex apex locators in detecting horizontal and vertical root fractures: an in vitro study. SADJ 2006; 61: 244- 247.
D'Assuncao FL, Sousa JC, Felinto KC, de Medeiros TC, Leite DT, de Lucena RB, et al. Accuracy and repeatability of 3 apex locators in locating root canal perforations: an ex vivo study. J Endod 2014; 40: 1241-1244.
Shin HS, Yang WK, Kim MR, Ko HJ, Cho KM, Park SH, et al. Accuracy of Root ZX in teeth with simulated root per -foration in the presence of gel or liquid type endodontic irrigant. Restor Dent Endod 2012; 37: 149-154.
Herrera M, Abalos C, Lucena C, Jimenez-Planas A, Lla -mas R. Critical diameter of apical foramen and of file size using the Root ZX apex locator: an in vitro study. J Endod 2011; 37: 1306-1309.
Lee SJ, Nam KC, Kim DW. Clinical accuracy of a new apex locator with an automatic compensation circuit. J Endod 2002; 28 706-709.