Apex location

Apex location is a method of determining the length of the root canal of a tooth - manually or with a mechanical canal instrument that passes a low intensity electric current through the tooth.

The electrical characteristics of the tooth structure are measured and the exact position of the instrument in the tooth is determined. When the tool tip touches the top of the tooth, the instrument signals that the apical foramen is reached. Whenever the channel instrument is pulled out its length can be measured to determine the depth of the root canal and all other dental tools can be adjusted to this length.

Methods of measurement

Method of Prof. Sonada

The method of Prof. Sonada measures the canal's impedance using one or more electric frequencies. The method tracks the penetration of the instrument in the canal. It is unreliable though in the presence of fluid in the canal which requires additional drying.

Method of Prof. Kobayashi

The method of Professor Kobayashi performs a calculation of the ratio of the measured impedance of two or more electric frequencies. The method is highly accurate in the presence of fluid in the root canal. The method does not provide good monitoring of the penetration before reaching the apex. This method faces difficulties when working in a dry canal. Therefore the canal should be moistened. After measurement the canal should be dried.

Adaptive method

The Adaptive method of measurement is implemented by the so-called electronic apex locator. In the process of penetrating the instrument makes continuous measurements and selects a suitable method of measurement. In case of dry canal the device uses the method of Prof. Sonada. In case of wet canal the device automatically adjusts the measurement method of Professor Kobayashi. The adaptive method is highly accurate and does not require moistening or drying the canal.

References

Adaptive methods for apex location
Color Atlas and Textbook of Oral Anatomy, Histology, and Embryology by B. K. Berkovitz, G. R. Holland, B. J. Moxham Hardcover,

Endodontology (ICD-9-CM V3 23.0–23.2+23.7, ICD-10-PCS 0C?W–X)

Tests	Dental radiography Electric pulp test

Tools	Amalgam Dental dam EDTA Electronic apex locator Eucalyptol Files and reamers Gutta-percha Operating microscope Rotary technology Saline Silverpoints Sodium hypochlorite

Procedures	Apicoectomy Endodontic retreatment Endodontic therapy Regenerative endodontics Internal bleaching Pulpotomy Pulp capping

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