Comparing Different Electronic Apex Locators and Periapical Radiography on Postoperative Pain

Summary

This clinical study was conducted to better understand whether the method used to measure the length of root canals affects the amount of pain patients feel after root canal treatment. Accurate measurement of the root canal is important to clean and fill the tooth properly. If the canal is cleaned too short or too far, it may cause discomfort or reduce the success of the treatment.The study included 125 adult patients who had deep decay but no current pain or swelling. All had single-rooted teeth diagnosed with asymptomatic irreversible pulpitis. Participants were randomly divided into five groups, each using a different method to measure the root canal length before treatment. Four of the methods used electronic devices (called apex locators), and one used a dental X-ray. None of the patients knew which method was used in their case, and all treatments were done by the same dentist in a single appointment.Pain levels were recorded using a simple pain scale called the Visual Analog Scale (VAS), where patients marked their pain level at 6, 12, 24, and 48 hours after treatment. Patients were also allowed to take painkillers if needed, and they were asked to record how many tablets they used.The study also looked at factors like age, gender, the location of the treated tooth, and use of pain medication. The study was carried out at Bezmialem Vakif University's Department of Endodontics. All participants gave written consent, and the study was approved by the university's ethics committee. No complications or serious side effects were reported during or after the treatment.

Conditions

• Postoperative Acute Pain

Interventions

DEVICE

Root ZX (Morita Corp., Tokyo, Japan)

Root ZX (Morita Corp., Tokyo, Japan) is a well-established electronic apex locator widely used in endodontics for determining working length during root canal procedures. It operates based on the ratio method and has been shown to provide reliable and accurate measurements even in the presence of various irrigants. Root ZX has been extensively validated in clinical and laboratory studies and is considered a gold standard among apex locators.

DEVICE

Propex Pixi (Dentsply Maillefer, Ballaigues, Switzerland)

Propex Pixi (Dentsply Maillefer, Ballaigues, Switzerland) is a compact electronic apex locator designed to determine the working length of root canals with high accuracy. It uses advanced multi-frequency technology to detect the position of the apical foramen and provides real-time feedback through visual and audible signals. Despite its small size, Propex Pixi has demonstrated reliable performance in various clinical settings.

DEVICE

Woodpex III (Woodpecker Medical Instrument Co., Guilin, China)

Woodpex III (Woodpecker Medical Instrument Co., Guilin, China) is an electronic apex locator that operates using dual-frequency impedance technology to determine the working length of root canals. It features a user-friendly interface with visual and audible indicators, making it suitable for routine clinical use. While it is considered a cost-effective alternative to premium apex locators, studies have shown variable accuracy depending on canal conditions and the presence of irrigants.

DEVICE

Raypex 6 (VDW, Munich, Germany)

Raypex 6 (VDW, Munich, Germany) is a modern electronic apex locator that utilizes multi-frequency technology to accurately detect the apical constriction during root canal procedures. It features a color-coded graphical display and audible signals to guide clinicians throughout the procedure. Raypex 6 has been reported to provide reliable working length measurements even under challenging clinical conditions.

DEVICE

periapical radiography

Working length determination using periapical radiography involves placing a small endodontic file inside the root canal and taking a radiograph to estimate the position of the file tip relative to the root apex. This traditional technique is widely used but may be limited by image distortion, anatomical variations, and the two-dimensional nature of radiographs. Despite its limitations, it remains a common reference method in endodontic practice.

Sponsors & Collaborators

• Bezmialem Vakif University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

TRIPLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

60 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-10-01

Primary Completion

2024-01-01

Completion

2025-08-01

Countries

• Turkey (Türkiye)

Study Locations