Apex Locator Calibration

[Lcs Basinger]

Application in Retreatment
HFC can be used to cauterize infected tissue and contaminants inside and around the root canal.
After cauterization, symptoms are expected to improve due to the natural healing process of the human body.

Wide Range of Root Canal Treatment Applications
HFC is effective to cauterize infected tissue in un-instrumented areas and in the granulation. The hemostasis that results from HFC allows for further stability in the apex location.

Try it for 30 days in your operatory. If for some reason you are not completely satisfied with your purchase, you may return Root ZX3 and the module for a refund. After the trial period, you have 7 days to return the units. If returned, shipping charges on the delivery ONLY may apply. The Root ZX3 apex locator and the HF Module must be purchased together. J. MORITA USA reserves the right to change or cancel this promotion at any time.

Make sure your apex locator has a decent charge or it may not be accurate. I have to swap out the batteries in mine from time to time, so I invested in some rechargeable ones and always have some charging just in case my batteries die spontaneously!

How To Use Your Endodontic Apex Locator SuccessfullyWorking with Gutta Percha in a Tooth: Troubleshooting a Common ScenarioE-School is a virtual endodontic course that helps general dentists enhance patient outcomes, build knowledge, and increase revenue.Join the E-School Wait List to Learn when E-School with Coaching Is Available

Hi! Thank you for your post. No, missing walls should have no impact, unless it effects your isolation. But, you can always build up that wall or seal it off with something like Opaldam to keep any moisture out. Hope this helps.

Mam I put my working length 0.5mm short of the apex wt I think is that working length varies as we complete the bmp. If I put wl at zero zero then there might be chances of over instrumention. Give me ur advice tnxs.

Farin,
Sometimes my apex locator works when it is wet. These are just guidelines if your apex locator starts to act up on you. So, you will need to take the time to get to know your particular apex locator so you can know when to make adjustments when necessary. If it chirps, then dry it and try again. If it still chirps, turn it off and take a radiograph.

I have only used the apex locators that you see in the picture. I would suggest asking the representative that sold you the unit to get complete clarification. But, my assumption is that 0.0 is the where you need to go on all units. Good luck!!

Sonia , if you feel confident about your 0/0 reading on your apex locator, do you still take a verification radiograph? Also, I agree that a loose fitting file can give u a false reading. I often time will use my SX1 file as the file and turn it clockwise until it goes to 0. If I need an X-ray the file will not move.

Grete tips!
I am using Densply apex locator. Sometimes after receiving signals for apex (some short of it) and further widening ,on sbsequent mesuring it does nor give sigal, or signals r idicative of short length for the same length. What could be the reason and how to tackle ir?

Hello Dr. Chopra,
As everyone mentioned great post. I loved your SLOB rule explanation as well.
1. My question for Apex locator is that, if you have discrepancy between Working length of Apex locator and radiograph which WL would you consider?
2. Also, would you go par apex to confirm WL with apex locator?

Sometimes my apex locator does not tell me the truth, so I have to trust my radiograph too. If it looks short, I extend, if it is long, I back it up. I always try to go out about 1mm with a small file to calibrate my apex locator and then I get my length. I hope this helps.

Yes and No. The apex locator will start to ring out once it hits the outside part of the tooth, so yes it still works, but it is hard to read the locator in those situations so you may still want to confirm with a radiograph.
-Sonia

Hi Dr. Chopra,
Thank you for your blog! It is very kind of you to share your knowledge. I love Endo when it works out! Sometimes the apex of the canal is shorter than the length of the root. How do you when that is the case?

Hi there! Since this is not something that you can see, I would trust what your apex locator is telling you. However, in the beginning I always recommend also taking a working length film to gauge your apex locator. Hope this helps.
-Sonia

Hi doctor.
So I encountered a case ( 36) where my file is inside the mesiobuccal canal (0.5mm short- confirmed on radiograph) but no reading is shown in my apex locator for this canal alone.
Remaining three canals show accurate reading on the apex locator.
How do I go about this?

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Electronic digital imaging systems provide the clinician with the ability to manipulate, enhance, and store radiographic images for immediate recall. Apex locators are a useful adjunct to endodontic therapy. It is important to understand that they do not replace radiographs completely in treatment. Radiographs 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 root anatomy; the relationship of the crown to the root; the size, shape, curvature, and location of the roots; and to estimate the tooth length. These data give the clinician a good guide and provide a baseline from which to use an apex locator. Failure to do this will result in errors of measurement due to a lack of basic treatment information. The current types of apex locators available are accurate for determining working length, providing some basic steps are followed carefully for their use. Current generation units have degrees of accuracy that range from 83.0% to 93.4%. They need to have well-charged batteries and to be calibrated correctly before use. Resistance-type apex locators require a reasonably dry canal--a guideline that must be strictly followed. Files must be matched to fit the canal snugly, contact against metallic restorations must be avoided, and good lip contact for the return electrode must be obtained. The impedance-type units require careful calibration before use, careful matching of the coated probe to the canal diameter, and good patient contact with the hand-held return electrode. Care must be taken to ensure that the insulating layer does not wear off the coated probes during use. The frequency-based units are easy to use. They operate in an electroconductive environment and have the advantage of using conventional K-type files. However, the rechargeable battery must be kept fully charged, and their calibration steps must be followed. Fluid filling the tooth to the level of the pulp chamber will cause the units to become overloaded, and careful matching of the file to the size of the canal is necessary. Strict adherence to these simple set-up and calibration procedures and the use of the apex locator in conjunction with high-quality, standardized diagnostic radiographs provide the clinician with an accurate and useful adjunct to endodontic therapy.

Woodpecker Calibration Tester for Woodpex Apex Locators. The Woodpecker Woodpex 3 Calibration Tester is a vital tool for dentists who use the Woodpex III Apex Locator for root canal procedures. This small device ensures the accuracy of the apex locator, which is critical for measuring the length of the root canal and avoiding damage to the tooth.

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Measurement of the length of the canal should only be done once the coronal 2/3rds of the canal has been shaped and cleaned. This will eliminate dentinal shelves in molars as well as, eliminating considerable debris and bacteria from the canal system. Often in roots with severe curvatures, the length is shortened slightly during routine shaping, thus confirming the length at this stage will enhance the accuracy of the readings. Like any electronic device short circuits will render the unit inoperative. The current generation of EAL demand that the measuring electrode (usually a k-file) does not touch any metallic restorations, or be in contact with electrolyte solutions in the coronal pulp chamber. If the unit registers on insertion of the file into the access opening, check that the file is not contacting any metallic restorations, and that the coronal pulp chamber is dry. Often solutions in the pulp chamber can cause a short circuit. This is especially important in multi rooted teeth, as the canals must be isolated from one another. If the unit registers as the file is placed in the canal even after drying, some ethanol can be placed in the coronal pulp chamber and gently blown dry. This will dehydrate the coronal pulp chamber and the coronal few mm of root canal allowing you to get a more accurate reading. If isolation from a metallic restoration is a problem you can paint the upper part of the k-file with nail varnish thus providing an insulating barrier. Another alternative is to fill the access cavity with a non conducting gel (iso-gel: Acadental).

In cases where the access is very difficult due to coronal calcifications you can check for possible perforations during this difficult procedure by using your apex locator to determine if you have made a small perforation. If you discover a small catch, which you are not sure is the canal or a perforation into the furcation or periodontal ligament space, use of the EAL can confirm this prior to creating an insolvable problem. Hook up your apex locator and place the tip of the k-file into the catch. If you get a reading that the apex has been reached, you might be dealing with a perforation. This can be confirmed with radiographs. (Ensure the file is not touching a metallic restoration as this will give the same result.) At the mid root level a similar reading might be indicative of a horizontal root fracture, or even a large lateral canal.

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