APEX LOCATOR

By: NATIVIDAD, Queen Charmaine P.

HISTORY OF ELECTRONIC APEX

LOCATOR
First investigated by Custer (1918)
The idea was revisited by Suzuki in 1942 who
studied the flow of direct current through the
teeth of dogs. He registered consistent values in
electrical resistance between an instrument in a
root canal and an electrode on the oral mucous
membrane and speculated that this would
measure the canal length
Sunada took these principles and constructed a
simple device that used direct current to measure
the canal length

HISTORY OF ELECTRONIC APEX

LOCATOR

It worked on the principle that the electrical

resistance of the mucous membrane and the
periodontium registered 6.0k in any part of the
periodontium of the persons age or the shape and
type of the teeth (Sunada 1962).

APEX LOCATOR
Instrument used in endodontics to determine the
working length in root canal treatment as an
adjunct to radiography
Used to locate the apical foramen by determining
the apical constriction

ROOT CANAL TERMINUS

ADVANTAGES
Easy and fast
Reduction of exposure to radiation
Perforations can be detected
Can measure pulp space exactly to the
constriction
Can detect resorption and root fracture

USES/INDICATIONS
Modern apex locators are able to detect root
perforations to clinically acceptable limits and are
equally able to distinguish both large and small
perforations.
Any fractures, cracks and internal or external
resorption will be recognized
For patients who cannot tolerate radiographic film
placement because of gag reflex
Can be a valuable tool to reduce radiation exposure
in pregnant patients
Can also be used in case of children who may not
tolerate taking radiographs, disabled patients, and
patients who are heavily sedated

CONTRAINDICATION

Patients who have cardiac pacemaker functions

1st Generation

2nd

3rd

4th

5th

6th

Resistance

Generation

Generation

Generation

Generation

Generation
Adaptive
Apex
Locator

Impedance Frequency
Dependent
Principle

Works on the

Works on the

Works on the

Measure the

Can measure

combines the

principle of

principles of

principle of

resistance and

pulp space

advantages of

resistance offered impedance by

frequency of

capacitance

lengths

the methods for

by periodontal

Comparitive

separately

accurately even measuring in

impedence

rather than the in the

dry canals and

in moist canals

measuring

ligament and oral opposition to

mucous

flow of

resultant

presence of

membrane is the

alternating

impedance

conductive

same

current or

value

fluids.

impedance
Advantages - Digital read out - Does not
- Detects

require lip clip

perforation

- No patient
sensitivity
- Analog
method

- Audible

- measures

- digital read
out
indication
separately for
- Can operate in better accuracy -Can be used
whether pulp
presence of
and thus less
space is wet,
fluids
chances of
dry or filled
- Analog read
occurance of
with any
out
errors
conductive
fluids

Disadvanta

- Requires a dry

- No digital

- Chances of

-need to

experience

ges

field

read out

short circuit

perform in

considerable

- Requires

- Difficult to

relatively dry

difficulties

-can be used
whether
there is
moisture, nonextirped pulp,
exudates,
irrigants, dry or
dried canal

THE FIRST GENERATION

NEOSONO ULTIMA EZ

SECOND GENERATION
FORMATRON IV

THIRD GENERATION - MORITA

FOURTH GENERATION TRIAUTO

ZX

FIFTH GENERATION JOYPEX 5

SIXTH GENERATION - ADAPTIVE

APEX LOCATOR

HOW IT WORKS

PROBLEMS ASSOCIATED WITH THE

USE OF APEX LOCATORS
Canal Shape
Cardiac Pacemakers
Unstable electronic signal with rapid wandering
signs
Sharp drop of the signal at the apical foramen
Apex sign from the beginning
Premature reading
short-circuiting

CASE PRESENTATION
A 75-year-old patient required endodontic
treatment on an upper bicuspid that had been
recently crowned. The radiograph revealed that
the canals appeared to be calcified.
Endodontic therapy was started using the
surgical microscope. The access opening was
made through the crown and the tooth was
transilluminated in order to find the orifices into
the canals. A white dot was seen at high
magnification. A #8 file was introduced into what
appeared to be a canal and it was connected to
one of the electrodes of an apex locator.

CASE PRESENTATION

The device registered an "in canal" reading. A

second canal was found using the same
technique. A radiograph was taken to confirm the
working length and the location of the canals.