Accuracy of a new apex locator: an in vitro study

The purpose of this study was to test in an in vitro model the accuracy of a Bingo 1020 electronic apex locator, to compare the results to those of a well known apex locator, Root ZX, as well as to those of the radiographic method of tooth length determination.

A total of 120 extracted teeth, preserved in Thymol solution and kept refrigerated, was used for the study. The experiment was performed on single-rooted teeth and on one-root canal, chosen randomly, in multirooted teeth. The teeth were randomly divided into 12 groups of 10 teeth each. After access preparation, the actual length (AL) was measured. The teeth were embedded in an alginate model specially developed for testing apex locators. Electronic tooth length measurements (EL) were carried out prior to root canal preparation using the two electronic apex locators (EAL) - Root ZX and Bingo 1020; three measurements were taken and an average computed. After the third measurement, the file was left in the root canal and a periapical radiograph was taken. The radiographic length (RL) was recorded by measuring the file length from the coronal reference point to the tip of the file. Each root canal was then prepared to a no. 40 K-file diameter using a standardized technique; saline was used for irrigation. Upon completion of the root canal preparation, EL measurements were taken by each EAL in dry conditions and with different irrigation solutions. Each measurement was repeated three times. The RL was recorded according to the last EL measurement. Results were subjected to statistical analysis.

In all parameters tested, a significant statistical difference was found between Bingo 1020 and the Root ZX. Measurements obtained using the Bingo 1020 were consistently closer to the AL (0.08 mm) than those obtained using the Root ZX. Both EALs measured the tooth length with great accuracy and a positive correlation of 0.76 (P = 0.00) existed between the two devices. No significant difference was found between the two apex locators when measurements were taken with the different irrigants (P = 0.34) and the content of the root canal did not affect the accuracy of the measurements. Lengths obtained by calculations from the radiographs were longer than the AL as well as the length obtained by both EALs (P = 0.00).

The Bingo 1020 proved to be as reliable as Root ZX and was user friendly. Under the experimental conditions, electronic measurements were more reliable than radiographs in the process of root length determination.