Avaliação da acurácia de localizadores foraminais eletrônicos quanto à precisão na odontometria: Estudo Piloto EX VIVO

Abstract

The success of endodontic treatment is directly related to the accurate determination of the working length (WL), since errors at this stage can result in insufficient or excessive instrumentation, favoring the persistence of microorganisms, reinfections, postoperative pain, and compromised periapical healing. Electronic apex locators (EALs) have emerged as alternatives to conventional radiographic methods for WL determination, aiming to overcome their limitations and provide greater precision in identifying the transition between pulp and periodontal tissues. The objective of this study was to evaluate the accuracy of EALs in determining WL in 40 extracted human teeth, comparing them among themselves and in relation to the direct and radiographic methods. All samples were subjected to the three methods, considering 1.0 mm short of the apical foramen. The electronic devices tested included the reference apex locators Propex Pixi™ and E-PEX PRO, as well as the experimental devices Apex Locator AZ-1 and Micropex®. Group comparisons were performed using repeated measures ANOVA, method consistency was assessed by the Intraclass Correlation Coefficient, and multiple comparisons were made using Bonferroni-adjusted post hoc tests. Analyses were conducted with IBM SPSS Statistics® at a 0.05 significance level. The electronic apex locators showed high precision and consistent results in WL determination in extracted human teeth, with similar performance among themselves and compared to the direct and radiographic methods. Despite the absence of statistically significant differences, the radiographic method may be affected by anatomical variations between the radiographic root apex and the apical foramen, justifying the recommendation for combined use of techniques to ensure successful endodontic treatment. The importance of device regulation for clinical practice and the need for further studies to confirm these results are also highlighted.