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ENDO FACTS
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Drs. Schiff, Simons, & Hernandez
A Monthly Broadcast
Melbourne, FL (407) 259-2507 |
Cocoa Beach, FL (407) 799-9721 |
September 1, 1998
Bradley L. Schiff, Editor
Titusville, FL (407) 287-8319 |
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THE APICAL FORAMEN - ARE WE THERE YET!
The Electronic Determination of the Working Length
One important factor in successful endodontic treatment is the correct determination of the length of the root canal. In order to achieve an effective biomechanical preparation and obturation of the canal system, it is necessary for this measurement to be as accurate as possible. Currently, the most popular method for determining proper root canal length depends a great deal on radiographic interpretation; however, there are inherent problems associated with using radiographs. These include image distortion, radiographic interpretation of the clinician, and interference of anatomical structures. Radiation hygiene (almost eliminated with digital radiography) is also a consideration. These factors have stimulated the development of apex locators, which reportedly can locate the position of the apical foramen.
HOW IT WORKS:
The periodontal membrane and the oral mucosa have identical electrical resistance, which is a constant value of 6.5 KiloOhms. The resistance value of 6.5 KiloOhms is built into the electronic circuitry contained inside of the apex locator. One side of the apex locator circuit is connected to oral mucosa through a lip clip and the other side to a file. When the file is placed into the root canal and advanced apically until its lip touches periodontal tissue at the apex, the electrical circuit is completed.
ADVANTAGES:
- Indicates accurate root length most of the time.
- Reduces operating time, once clinician becomes proficient with the device.
- Increase accuracy of endodontic treatment.
- Reduces the number of radiographs needed and radiation exposure to patient.
- When radiographs are contraindicated (many obstetricians do not allow radiographs to be taken in the first trimester of a pregnancy, even in an emergency situation).
- Patient with a strong gag reflex: a small percentage of patients will not tolerate the placement of film in the posterior region of the mouth.
OUR EXPERIENCE:
Apex locators have been used in dentistry for many years, but have not achieved acceptance by the majority of clinicians. Over the last ten years, there has been a considerable advancement in apex locator technology. We have been using apex locators in routine endodontic procedures for the past year. Although we are able to interpret the apex locator signal in the majority of cases, we still believe that they do not replace radiographs completely in treatment. Radiographs (now digital radiography) still provide the only means by which the clinician can gain an overall visual image of the tooth being treated. It is important to visualize the crown and tooth anatomy; the relationship of the crown to the root; the size, shape and curvature and location of the roots. Overall we can say that apex locators have been a useful adjunct to our endodontic practice.
ENDO FACTS is intended to aid the practitioner in the management of endodontic conditions. Practitioners must always use their own best professional judgement. We neither expressly nor implicitly warrant any positive results associated with this material.
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