The effect of different root canal irrigations on the accuracy of apex locators: A systematic review

For a successful root canal treatment, it is necessary to determine the correct working length. One of the most used tools to determine the length is: radiography and apex locator. The accuracy of APEX locator of different generations depends on various factors. Studies have reported various effects of root canal irrigations on Apex Locator accuracy. This review study collects the results of studies conducted in recent years so that dentists and specialists can choose the most appropriate root canal irrigation's protocol with the least negative impact on the accuracy of Apex Locator.

This review article has been done in the form of a wide search in electronic databases such as MEDLINE, PubMed, BVS (Lilacs and BBO), Scopus, Web of Science, Cochrane Library and Embase in the period of 2010-2023. No language restrictions have been considered and the reference list of all related articles has been checked.

Out of 605 found articles, After removing duplicates and an initial screening, the full texts of only 25 articles are analyed and only 21 articles matched our inclusion criteria and their quality was assessed using modified CONSORT. This article is written based on the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses protocol protocol. Based on the obtained results, use of hypochlorite alone, which has a negative effect on the accuracy of the apex locator due to its high electroconductivity.

Use of a irrigation's protocol such as the use of 17% Ethylenediaminetetraacetic acid (EDTA) after sodium hypochlorite or chlorhexidine (CHX) or 0.1% octinidine dohydrochloride (OCT) is suggested compared to the use of sodium hypochlorite alone. Key words:Apex locator, irrigation solutions, sodium hypochlorite, Chlorhexidine, working length.