In Vitro Evaluation of the Accuracy of Three Electronic Apex Locators Using Different Sodium Hypochlorite Concentrations

Background and Objectives: The aim of this study was to compare the accuracy of three types of electronic apex locators (EALs) when two different concentrations of NaOCl irrigation solutions are used by two operators. Materials and Methods: After creating the access cavities for 20 single rooted extracted teeth, the actual canal length (ACL) of each canal was determined visually using a #10 file and magnification. The teeth were subsequently inserted in plastic molds filled with alginate. The electronic measurement of root canal length (EWL) was performed using three different electronic apex locators: Root ZX II, Apex ID, and Dual Pex. Two independent operators, an endodontic specialist with 20 years practice and an undergraduate student in the final year of study, performed the irrigation procedures with two different concentrations of NaOCl (2% and 5.25%), and then measured the EWL using each of the EALs. The accuracy of all EALs, was determined in each case by subtracting the EWL from the ACL. Statistical analyses were performed using one-way ANOVA test. Results: In the presence of 2% NaOCl solution, for a margin error of ±0.5 mm, Root ZX II, Apex ID, and Dual Pex presented an accuracy of 90%, 80%, and 85% respectively. The increase in the concentration of the irrigation solution affected the accuracy of Root ZX II and Apex ID for both operators, diminishing it to 75% for the same margin error, but improved Dual Pex’s accuracy to 100%. Conclusions: The best accuracy in working length determination was obtained by Root ZX II for 2% NaOCl solution and by Dual Pex for 5.25% NaOCl solution with no significant statistical difference when compared.