Ektronik Apeks Bulucular ve Entegre Endomotor Sistemleri
Özet
Bu bölümde kök kanal tedavisinde çalışma boyunun doğru belirlenmesinin önemi ve bu amaçla kullanılan elektronik apeks bulucuların gelişimi ele alınmaktadır. Çalışma boyunun doğru belirlenmesi, apikal daralımın korunması, mikroorganizma eliminasyonu ve periapikal dokuların iyileşmesi açısından kritik öneme sahiptir. Geleneksel çalışma boyu belirleme yöntemleri arasında parmak hassasiyeti, kağıt kon tekniği ve radyografik değerlendirme yer almakla birlikte bu yöntemlerin çeşitli sınırlılıkları bulunmaktadır. Elektronik apeks bulucular, kök kanal sistemi ve periodonsiyum arasındaki elektriksel iletimden yararlanarak eğe ucunun kök kanalı içerisindeki konumunu belirleyebilmekte ve günümüzde çalışma boyu tayininde yaygın olarak kullanılmaktadır. Cihazların çalışma prensibi; empedans, direnç ve kapasitans değişimlerinin analizine dayanır. Bölümde elektronik apeks bulucuların tarihsel gelişimi, birinci nesilden altıncı nesle kadar olan teknolojik ilerlemeler ve çalışma prensipleri açıklanmaktadır. Ayrıca ölçüm doğruluğunu etkileyebilen faktörler (kanal içi ortam, anatomik değişiklikler, eğe boyutu vb.) ve bu cihazların avantaj–dezavantajları da tartışılmaktadır. Son olarak elektronik apeks bulucu entegre endomotor sistemleri ve bu sistemlerde kullanılan apikal geri dönüş ve apikal durdurma gibi çalışma boyu kontrol mekanizmaları ele alınmaktadır.
This chapter discusses the importance of accurate working length determination in root canal treatment and reviews the development of electronic apex locators used for this purpose. Precise determination of the working length is critical for preserving the apical constriction, ensuring effective microbial elimination, and promoting the healing of periapical tissues. Traditional methods for determining working length include tactile sensation, the paper point technique, and radiographic assessment; however, these approaches present several limitations. Electronic apex locators determine the position of the file within the root canal by utilizing the electrical conductivity between the root canal system and the periodontal tissues, and they are currently widely used in working length determination. The operating principle of these devices is based on the analysis of changes in impedance, resistance, and capacitance. The chapter outlines the historical development of electronic apex locators, describing technological advancements from the first generation to the sixth generation and explaining their underlying operating principles. In addition, factors that may influence measurement accuracy—such as intracanal conditions, anatomical variations, and file size—are discussed, along with the advantages and limitations of these devices. Finally, apex locator–integrated endodontic motor systems and their working length control mechanisms, including functions such as auto-apical reverse and auto-apical stop, are addressed.
Referanslar
Kuttler Y. Microscopic investigation of root apexes. The Journal of the American Dental Association. 1955;50(5):544-52.
Green D. Stereomicroscopic study of 700 root apices of maxillary and mandibular posterior teeth. Oral Surgery, Oral Medicine, Oral Pathology. 1960;13(6):728-33.
Tsesis I, Blazer T, Ben-Izhack G, Taschieri S, Del Fabbro M, Corbella S, et al. The precision of electronic apex locators in working length determination: a systematic review and meta-analysis of the literature. Journal of endodontics. 2015;41(11):1818-23.
doi: 10.1016/j.joen.2015.08.012
Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endodontic topics. 2005;10(1):3-29.
doi: 10.1111/j.1601-1546.2005.00129.x
Palmer M, Weine F, Healey H. Position of the apical foramen in relation to endodontic therapy. Journal of the Canadian Dental Association. 1971;37(8):305-8.
Chugal N, Mallya SM, Kahler B, Lin LM. Endodontic treatment outcomes. Dental Clinics. 2017;61(1):59-80.
doi: 10.1016/j.cden.2016.08.009
Alaçam, T. Endodonti. Ankara: Özyurt Matbaacılık; 2012.
Ricucci. Apical limit of root canal instrumentation and obturation, part 1. Literature review. International Endodontic Journal. 1998;31(6):384-93.
doi: 10.1046/j.1365-2591.1998.00184.x
Stock C. Endodontics--position of the apical seal. British dental journal. 1994;176(9):329.
doi: 10.1038/sj.bdj.4808442
Brown D. Paper points revisited: risk of cellulose fibre shedding during canal length confirmation. International endodontic journal. 2017;50(6):620-6.
doi: 10.1111/iej.12663
Tınaz C. Kanal tedavisinde çalışma boyutu. Gazi Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2001;18(1):31-7.
Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. Journal of endodontics. 2005;31(4):271-4.
doi: 10.1097/01.don.0000140585.52178.78
Kim E, Lee S-J. Electronic apex locator. Dental Clinics. 2004;48(1):35-54.
doi: 10.1016/j.cden.2003.10.005
Ebrahim A, Wadachi R, Suda H. An in vitro evaluation of the accuracy of Dentaport ZX apex locator in enlarged root canals. Australian dental journal. 2007;52(3):193-7.
doi: 10.1111/j.1834-7819.2007.tb00488.x
Nekoofar M, Ghandi M, Hayes S, Dummer P. The fundamental operating principles of electronic root canal length measurement devices. International endodontic journal. 2006;39(8):595-609.
doi: 10.1111/j.1365-2591.2006.01131.x
Custer L. Exact methods of locating the apical foramen. The Journal of the National Dental Association. 1918;5(8):815-9.
Suzuki K. Experimental study on iontophoresis. Jpn J Stomatology. 1942;16:411-29.
Gordon M, Chandler N. Electronic apex locators. International endodontic journal. 2004;37(7):425-37.
doi: 10.1111/j.1365-2591.2004.00835.x
Bridges JE. Non‐perceptible body current ELF effects as defined by electric shock safety data. Bioelectromagnetics: Journal of the Bioelectromagnetics Society, The Society for Physical Regulation in Biology and Medicine, The European Bioelectromagnetics Association. 2002;23(7):542-4.
doi: 10.1002/bem.10063
Niple J, Daigle J, Zaffanella L, Sullivan T, Kavet R. A portable meter for measuring low frequency currents in the human body. Bioelectromagnetics: Journal of the Bioelectromagnetics Society, The Society for Physical Regulation in Biology and Medicine, The European Bioelectromagnetics Association. 2004;25(5):369-73.
doi: 10.1002/bem.20000
Kim PJ, Kim HG, Cho BH. Evaluation of electrical impedance ratio measurements in accuracy of electronic apex locators. Restor Dent Endod. 2015;40(2):113-22.
doi: 10.5395/rde.2015.40.2.113
Pommer O, Stamm O, Attin T. Influence of the canal contents on the electrical assisted determination of the length of root canals. Journal of Endodontics. 2002;28(2):83-5.
doi: 10.1097/00004770-200202000-00002
Stock CJ, Gulabivala K, Walker RT. Endodontics. Edinburgh: Mosby/Elsevier Ltd; 2004.
Soi S, Mohan S, Kaur VVP. Electronic apex locators. J Dent Sci Oral Rehabil. 2013;24-29.
Kobayashi C, Matoba K, Suda H, Sunada I. New practical model of the division method electronic root canal length measuring device. J Jpn Endodon Assoc. 1991;12:143-8.
Lucena-Martin C, Robles-Gijon V, Ferrer-Luque C, de Mondelo JN-R. In vitro evaluation of the accuracy of three electronic apex locators. Journal of Endodontics. 2004;30(4):231-3.
doi: 10.1097/00004770-200404000-00012.
Kaufman A, Keila S, Yoshpe M. Accuracy of a new apex locator: an in vitro study. International endodontic journal. 2002;35(2):186-92.
doi: 10.1046/j.1365-2591.2002.00468.x
Mancini M, Felici R, Conte G, Costantini M, Cianconi L. Accuracy of three electronic apex locators in anterior and posterior teeth: an ex vivo study. Journal of endodontics. 2011;37(5):684-7.
doi: 10.1016/j.joen.2010.12.009
Bonilla M, Sayin TC, Schobert B, Hardigan P. Accuracy of a new apex locator in ex-vivo teeth using scanning electron microscopy. Endod Pract. 2014;16:14-20.
Stoll R, Urban‐Klein B, Roggendorf M, Jablonski‐Momeni A, Strauch K, Frankenberger R. Effectiveness of four electronic apex locators to determine distance from the apical foramen. International Endodontic Journal. 2010;43(9):808-17.
doi: 10.1111/j.1365-2591.2010.01751.x
Bhatt A, Gupta V, Rajkumar B, Arora R. Working Length Determination-The soul of Root Canal Therapy a Review. Int J Dent Health Sci. 2015;2(1):105-15.
Akisue E, Gavini G, de Figueiredo JAP. Influence of pulp vitality on length determination by using the Elements Diagnostic Unit and Apex Locator. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007;104(4):e129-e32.
doi: 10.1016/j.tripleo.2007.04.018
Bilaiya S, Patni PM, Jain P, Pandey SH, Raghuwanshi S, Bagulkar B. Comparative Evaluation of Accuracy of Ipex, Root Zx Mini, and Epex Pro Apex Locators in Teeth with Artificially Created Root Perforations in Presence of Various Intracanal Irrigants. European endodontic journal. 2020;5(1):6-9.
doi: 10.14744/eej.2019.07279
Shekarbaghani SA, Bolhari B, Khalilak Z. The effect of different root canal irrigations on the accuracy of apex locators: A systematic review. Journal of Clinical and Experimental Dentistry. 2024;16(12):e1538.
López-Maekawa A, García Rupay CR. Accuracy of Four Apex Locators in Premolars with Root Resorption: An In vitro Study. Iran Endod J. 2022;17(1):20-6.
doi: 10.22037/iej.v17i1.35498
Kararia N, Kararia V, Sharma D, Gupta S, Chaturvedi S, Chaturvedi Y. Comparative evaluation of the accuracy of two electronic apex locators in detecting simulated incomplete vertical root fractures: An in vitro stereomicroscopic study. J Conserv Dent Endod. 2024;27(5):540-4.
doi: 10.4103/jcde.jcde_132_24
Nekoofar M, Sadeghi K, Akha ES, Namazikhah MS. The accuracy of the Neosono Ultima EZ apex locator using files of different alloys: an in vitro study. Journal of the California Dental Association. 2002;30(9):681-4.
doi: 10.1080/19424396.2002.12223308
Kobayashi C. Electronic canal length measurement. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1995;79(2):226-31.
doi: 10.1016/S1079-2104(05)80288-4
de Almeida Gardelin V, Vinholes JIAM, Grazziotin‐Soares R, Pappen FG, Barletta FB. Influence of rotary and reciprocating kinematics on the accuracy of an integrated apex locator. Australian Endodontic Journal. 2023;49:202-8.
doi:10.1111/aej.12717
Shirazi Z, Al-Jadaa A, Saleh AR. Electronic apex locators and their implications in contemporary clinical practice: a review. The Open Dentistry Journal. 2023;17(1).
doi:10.2174/18742106-v16-e221227-2022-67
Technomedics. FKG Rooter X3000 Kullanım Kılavuzu 2021. (01/02/2026 tarihinde https://www.technomedics.no/wpcontent/uploads/2020/03/FKG_Rooter20X3000_User20Manual_EN_WEB_20210121.pdf. Adresinden ulaşılmıştır.)
Usta SN, Magan-Fernandez A, Aydın C. Evaluation of the effects of different file systems and apical functions of integrated endodontic motors on debris extrusion: an ex vivo experimental study. Restor Dent Endod. 2025;50(2):e14.
doi: 10.5395/rde.2025.50.e14
Equipment. A. Woodpecker Yoshi Ai Endo Motor Ürün Tanıtımı. (01/02/2026 tarihinde https://www.aluroequipment.co.nz/ adresinden ulaşılmıştır.)
Bailey D, Anderson R, Brady K, Kwon P, Browne D, Amaral RR. An ex-vivo study comparing the accuracy of the E-connect S+ and Morita Tri Auto ZX2+ endodontic handpieces in root canal length determination. Journal of endodontics. 2024;50(7):1004-10.
doi:10.1016/j.joen.2024.04.007
Referanslar
Kuttler Y. Microscopic investigation of root apexes. The Journal of the American Dental Association. 1955;50(5):544-52.
Green D. Stereomicroscopic study of 700 root apices of maxillary and mandibular posterior teeth. Oral Surgery, Oral Medicine, Oral Pathology. 1960;13(6):728-33.
Tsesis I, Blazer T, Ben-Izhack G, Taschieri S, Del Fabbro M, Corbella S, et al. The precision of electronic apex locators in working length determination: a systematic review and meta-analysis of the literature. Journal of endodontics. 2015;41(11):1818-23.
doi: 10.1016/j.joen.2015.08.012
Vertucci FJ. Root canal morphology and its relationship to endodontic procedures. Endodontic topics. 2005;10(1):3-29.
doi: 10.1111/j.1601-1546.2005.00129.x
Palmer M, Weine F, Healey H. Position of the apical foramen in relation to endodontic therapy. Journal of the Canadian Dental Association. 1971;37(8):305-8.
Chugal N, Mallya SM, Kahler B, Lin LM. Endodontic treatment outcomes. Dental Clinics. 2017;61(1):59-80.
doi: 10.1016/j.cden.2016.08.009
Alaçam, T. Endodonti. Ankara: Özyurt Matbaacılık; 2012.
Ricucci. Apical limit of root canal instrumentation and obturation, part 1. Literature review. International Endodontic Journal. 1998;31(6):384-93.
doi: 10.1046/j.1365-2591.1998.00184.x
Stock C. Endodontics--position of the apical seal. British dental journal. 1994;176(9):329.
doi: 10.1038/sj.bdj.4808442
Brown D. Paper points revisited: risk of cellulose fibre shedding during canal length confirmation. International endodontic journal. 2017;50(6):620-6.
doi: 10.1111/iej.12663
Tınaz C. Kanal tedavisinde çalışma boyutu. Gazi Üniversitesi Diş Hekimliği Fakültesi Dergisi. 2001;18(1):31-7.
Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. Journal of endodontics. 2005;31(4):271-4.
doi: 10.1097/01.don.0000140585.52178.78
Kim E, Lee S-J. Electronic apex locator. Dental Clinics. 2004;48(1):35-54.
doi: 10.1016/j.cden.2003.10.005
Ebrahim A, Wadachi R, Suda H. An in vitro evaluation of the accuracy of Dentaport ZX apex locator in enlarged root canals. Australian dental journal. 2007;52(3):193-7.
doi: 10.1111/j.1834-7819.2007.tb00488.x
Nekoofar M, Ghandi M, Hayes S, Dummer P. The fundamental operating principles of electronic root canal length measurement devices. International endodontic journal. 2006;39(8):595-609.
doi: 10.1111/j.1365-2591.2006.01131.x
Custer L. Exact methods of locating the apical foramen. The Journal of the National Dental Association. 1918;5(8):815-9.
Suzuki K. Experimental study on iontophoresis. Jpn J Stomatology. 1942;16:411-29.
Gordon M, Chandler N. Electronic apex locators. International endodontic journal. 2004;37(7):425-37.
doi: 10.1111/j.1365-2591.2004.00835.x
Bridges JE. Non‐perceptible body current ELF effects as defined by electric shock safety data. Bioelectromagnetics: Journal of the Bioelectromagnetics Society, The Society for Physical Regulation in Biology and Medicine, The European Bioelectromagnetics Association. 2002;23(7):542-4.
doi: 10.1002/bem.10063
Niple J, Daigle J, Zaffanella L, Sullivan T, Kavet R. A portable meter for measuring low frequency currents in the human body. Bioelectromagnetics: Journal of the Bioelectromagnetics Society, The Society for Physical Regulation in Biology and Medicine, The European Bioelectromagnetics Association. 2004;25(5):369-73.
doi: 10.1002/bem.20000
Kim PJ, Kim HG, Cho BH. Evaluation of electrical impedance ratio measurements in accuracy of electronic apex locators. Restor Dent Endod. 2015;40(2):113-22.
doi: 10.5395/rde.2015.40.2.113
Pommer O, Stamm O, Attin T. Influence of the canal contents on the electrical assisted determination of the length of root canals. Journal of Endodontics. 2002;28(2):83-5.
doi: 10.1097/00004770-200202000-00002
Stock CJ, Gulabivala K, Walker RT. Endodontics. Edinburgh: Mosby/Elsevier Ltd; 2004.
Soi S, Mohan S, Kaur VVP. Electronic apex locators. J Dent Sci Oral Rehabil. 2013;24-29.
Kobayashi C, Matoba K, Suda H, Sunada I. New practical model of the division method electronic root canal length measuring device. J Jpn Endodon Assoc. 1991;12:143-8.
Lucena-Martin C, Robles-Gijon V, Ferrer-Luque C, de Mondelo JN-R. In vitro evaluation of the accuracy of three electronic apex locators. Journal of Endodontics. 2004;30(4):231-3.
doi: 10.1097/00004770-200404000-00012.
Kaufman A, Keila S, Yoshpe M. Accuracy of a new apex locator: an in vitro study. International endodontic journal. 2002;35(2):186-92.
doi: 10.1046/j.1365-2591.2002.00468.x
Mancini M, Felici R, Conte G, Costantini M, Cianconi L. Accuracy of three electronic apex locators in anterior and posterior teeth: an ex vivo study. Journal of endodontics. 2011;37(5):684-7.
doi: 10.1016/j.joen.2010.12.009
Bonilla M, Sayin TC, Schobert B, Hardigan P. Accuracy of a new apex locator in ex-vivo teeth using scanning electron microscopy. Endod Pract. 2014;16:14-20.
Stoll R, Urban‐Klein B, Roggendorf M, Jablonski‐Momeni A, Strauch K, Frankenberger R. Effectiveness of four electronic apex locators to determine distance from the apical foramen. International Endodontic Journal. 2010;43(9):808-17.
doi: 10.1111/j.1365-2591.2010.01751.x
Bhatt A, Gupta V, Rajkumar B, Arora R. Working Length Determination-The soul of Root Canal Therapy a Review. Int J Dent Health Sci. 2015;2(1):105-15.
Akisue E, Gavini G, de Figueiredo JAP. Influence of pulp vitality on length determination by using the Elements Diagnostic Unit and Apex Locator. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2007;104(4):e129-e32.
doi: 10.1016/j.tripleo.2007.04.018
Bilaiya S, Patni PM, Jain P, Pandey SH, Raghuwanshi S, Bagulkar B. Comparative Evaluation of Accuracy of Ipex, Root Zx Mini, and Epex Pro Apex Locators in Teeth with Artificially Created Root Perforations in Presence of Various Intracanal Irrigants. European endodontic journal. 2020;5(1):6-9.
doi: 10.14744/eej.2019.07279
Shekarbaghani SA, Bolhari B, Khalilak Z. The effect of different root canal irrigations on the accuracy of apex locators: A systematic review. Journal of Clinical and Experimental Dentistry. 2024;16(12):e1538.
López-Maekawa A, García Rupay CR. Accuracy of Four Apex Locators in Premolars with Root Resorption: An In vitro Study. Iran Endod J. 2022;17(1):20-6.
doi: 10.22037/iej.v17i1.35498
Kararia N, Kararia V, Sharma D, Gupta S, Chaturvedi S, Chaturvedi Y. Comparative evaluation of the accuracy of two electronic apex locators in detecting simulated incomplete vertical root fractures: An in vitro stereomicroscopic study. J Conserv Dent Endod. 2024;27(5):540-4.
doi: 10.4103/jcde.jcde_132_24
Nekoofar M, Sadeghi K, Akha ES, Namazikhah MS. The accuracy of the Neosono Ultima EZ apex locator using files of different alloys: an in vitro study. Journal of the California Dental Association. 2002;30(9):681-4.
doi: 10.1080/19424396.2002.12223308
Kobayashi C. Electronic canal length measurement. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1995;79(2):226-31.
doi: 10.1016/S1079-2104(05)80288-4
de Almeida Gardelin V, Vinholes JIAM, Grazziotin‐Soares R, Pappen FG, Barletta FB. Influence of rotary and reciprocating kinematics on the accuracy of an integrated apex locator. Australian Endodontic Journal. 2023;49:202-8.
doi:10.1111/aej.12717
Shirazi Z, Al-Jadaa A, Saleh AR. Electronic apex locators and their implications in contemporary clinical practice: a review. The Open Dentistry Journal. 2023;17(1).
doi:10.2174/18742106-v16-e221227-2022-67
Technomedics. FKG Rooter X3000 Kullanım Kılavuzu 2021. (01/02/2026 tarihinde https://www.technomedics.no/wpcontent/uploads/2020/03/FKG_Rooter20X3000_User20Manual_EN_WEB_20210121.pdf. Adresinden ulaşılmıştır.)
Usta SN, Magan-Fernandez A, Aydın C. Evaluation of the effects of different file systems and apical functions of integrated endodontic motors on debris extrusion: an ex vivo experimental study. Restor Dent Endod. 2025;50(2):e14.
doi: 10.5395/rde.2025.50.e14
Equipment. A. Woodpecker Yoshi Ai Endo Motor Ürün Tanıtımı. (01/02/2026 tarihinde https://www.aluroequipment.co.nz/ adresinden ulaşılmıştır.)
Bailey D, Anderson R, Brady K, Kwon P, Browne D, Amaral RR. An ex-vivo study comparing the accuracy of the E-connect S+ and Morita Tri Auto ZX2+ endodontic handpieces in root canal length determination. Journal of endodontics. 2024;50(7):1004-10.
doi:10.1016/j.joen.2024.04.007
