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Accuracy of electronic apex locators to detect root canal perforations with inserted metallic posts: an ex vivo study
Benjamín Briseño Marroquín1,2, Claudia Cortazar Fernández3, Irene Schmidtmann4
1Department of Operative Dentistry, Johannes Gutenberg University Medical Center, Mainz, Germany. briseno@uni-mainz.de.
Introduction:
The detection of possible root canal perforations caused during a metal post placement is frequently difficult to diagnose. The aim of this study was to investigate the accuracy of apex locators to diagnose such perforations.
Materials And Methods:
Thirty mesiolingual root canals of extracted mandibular molars were instrumented (30/.04) and a post space was prepared. A root canal perforation was intentionally made at the bi-furcation (n = 15). Metal posts were cemented in 15 perforated and 15 non-perforated root canals. The teeth roots were embedded in an agar-agar solution. The resulting measurements ("short" or "beyond" the apex) disclosed if a perforation could be identified with five different apex locators (ProPex II, Elements Apex Locator, Apex NRG, Raypex 5 and Raypex 6). The sensitivity and specificity (95% interval confidence) were calculated.
Results:
All devices excluded the absence of perforations (100% with 95% confidence interval [78%; 100%] specificity). The Apex NRG and Raypex 6 detected all perforations (100% with 95% confidence interval [78%; 100%] sensitivity). The ProPex II, Elements Apex Locator, and Raypex 5 detected 14 out of 15 perforations (93% with 95% confidence interval [68%; 100%] sensitivity).
Conclusions:
All devices determined root canal perforations, due to metallic posts, within clinical acceptable ranges.
