Influence of simulated apical resorption following orthodontic treatment on working length determination: an in vitro study

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ABSTRACT

Aim

External apical root resorption (EARR) is a common complication that may occur during and after orthodontic
treatment. In case of need of endodontic therapy for a tooth with EARR, it has not been clarified yet which benefits can be derived by
the use of electronic apex locators (EALs). The present study aimed to assess the accuracy of EALs on extracted teeth before and after
simulation of EARR subsequent to orthodontic treatment.

Methods

Standard access cavities were prepared on
64 single-rooted teeth. After working length (CWL) determination, specimens were embedded in an alginate mass, connected to two
EALs (Apit, Osada, Tokyo, Japan; Root ZX, Morita Corp., Tokyo, Japan) and the electronic working length (EWL) was measured. The
apical portion of the specimens was then modified to simulate EARR, and the EWL was determined again. The discrepancy between
CWL and EWL was regarded as statistical unit. Collected data underwent statistical analysis by means of non-parametric tests (p < 0.05).

Results

Within a range of 0.5 and 1.0 mm from CWL, the accuracies were 79.7 and 98.4
(Apit/intact tooth); 82.8 and 96.9 (Apit/simulated EARR); 81.3 and 98.4 (Root ZX/intact tooth);
76.6 and 96.9 (Root ZX/simulated EARR). No statistically significant differences in relation to device or apical condition
emerged (p > 0.05).

Conclusion

The two considered EALs showed similar accuracy, which was not affected by the EARR
simulation. The use of EALs in the treatment of teeth with EARR following orthodontic treatment may be useful.

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