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4.
PRECAUTIONS
Important notice:
The use of apex locators alone without a preoperative and postoperative radiograph
is not recommended practice, since apex locators may not be able to work properly
in all conditions. It is recommended to take an X-ray prior to the use of the unit, and
compare the information given by both means. In case of clinically relevant discrepancy,
it is recommended to take a second radiograph with a file in place at the selected
working length [European Society of Endodontology. Quality guidelines for endodontic
treatment: consensus report of the European Society of Endodontology. International
Endodontic Journal,39, 921–930, 2006.].
It is important to follow the precautions below and pay close attention to any condition or
situation that may influence the electrical conductivity during the procedure.
•
Inaccurate or incorrect readings are likely to occur in the following cases, all procedure
related:
- Partially blocked canal.
- Size of the measuring file differing significantly from the canal diameter. Ideally, the
selected file should be the thickest one capable of reaching the apex.
- Presence of liquids and/or tissue debris in the access cavity. Prior to the use of
the device, the access cavity must be dried with a cotton pellet in order to prevent
leaking current.
- Contact of the file or the lip clip with metallic dental structures. Be particularly careful
with patients fitted with metal crowns or bridges.
- Contact of the file with another instrument.
- Very dry canal, for instance in the presence of restoration. In this case the canal
must be moistened with an irrigation solution, or with Glyde
- Contact between the file and the gums (this may cause a false reading indicating
that the apex has been reached).
- Use of an ultrasonic scaler with the counter electrode attached to the patient
(electrical noise from the scaler could interfere with the apex localization).
- Use of the apex locator in conjunction with an electric scalpel.
- Use of a damaged lip clip, hook or fork.
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For apex localization, concentrations of NaOCl higher than 5 % may result in reduced
accuracy.
•
As a safety precaution in order to avoid over-instrumentation, it is recommended to
proceed as follows: place the file onto an endodontic ruler, where the propex
indicates '0.0'. Subtract a minimum of 0.5 mm from the measured file length.
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Please also respect the following precautions:
- For your own safety, be aware of wearing personal protective equipment (gloves,
glasses, mask).
- If the bar graph makes sudden large movements in the coronal part of the canal,
slowly continue advancing the file toward the apex until the signal returns to normal.
TM
8
file prep.
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