Accuracy of Working Length Determination - Electronic Apex Locator Versus Cone Beam Computed Tomography
Keywords:
Electronics, Endodontics, Mandible, MaxillaAbstract
Objective: To compare the accuracy of working length determination between cone beam computed tomography (CBCT) and electronic apex locator by measuring the actual working length of teeth. Material and Methods: A total of 150 single-rooted tooth assessed by radiograph undergoing root canal therapy were selected. The process was repeated to obtain a buccolingual and mesiodistal section of all teeth. The measurement line was considered from the reference occlusal plane following the center of the canal to the terminus. All information regarding the accuracy of cone-beam computed tomography and apex locator was noted in a pre-designed proforma. Results: CBCT consistently demonstrated high accuracy across all tooth types in both jaws. The electronic apex locator exhibited varying precision, with greater accuracy observed in the mandible. Statistical analyses revealed significant differences in electronic apex locator accuracy among tooth types in the maxilla (p=0.042), emphasizing the importance of specific clinical considerations. Conclusion: Cone beam computed tomography emerges as a reliable diagnostic tool for accurate working length determination, especially in complex cases, while the electronic apex locator remains valuable with careful consideration of potential variations in accuracy. An individualized approach, considering tooth type, jaw location, and clinical context, is crucial for precise working length determination in endodontic practice.References
Iparraguirre Nunovero MF, Piasecki L, Segato AVK, Westphalen VPD, Silva Neto UX, Carneiro E. A laboratory study of the accuracy of three electronic apex locators: Influence of embedding media and radiographic assessment of the electronic apical limit. Int Endod J 2021; 54(7):1200-1206. https://doi.org/10.1111/iej.13507
Simon S, Machtou P, Adams N, Tomson P, Lumley P. Apical limit and working length in endodontics. Dent Update 2009; 36(3):146-153. https://doi.org/10.12968/denu.2009.36.3.146
Khursheed I, Bansal R, Bansal T, Singh HP, Yadav M, Reddy KJ. A comparative evaluation of working length with digital radiography and third generation apex locator (ProPex) in the presence of various intracanal irrigants: An in vivo/ex vivo study. Dent Res J 2014; 11(1):56-60.
Osei-Bonsu F, Ampofo PC, Nyako EA, Hewlett SA, Buckman VA, Konadu AB, et al. Accuracy of the electronic apex locator, tactile, and radiographic methods in working length determination. J Conserv Dent 2023; 26(3):311. https://doi.org/10.4103/jcd.jcd_45_23
Keerthana G, Singh N, Yadav R, Duhan J, Tewari S, Gupta A, et al. Comparative analysis of the accuracy of periapical radiography and cone‐beam computed tomography for diagnosing complex endodontic pathoses using a gold standard reference – A prospective clinical study. Int Endod J 2021; 54(9):1448-1461. https://doi.org/10.1111/iej.13535
Yildirim C, Murat Aktan A, Karataslioglu E, Aksoy F, Isman O, Culha E. Performance of the working length determination using cone beam computed tomography, radiography and electronic apex locator, in comparisons to actual length. Iran J Radiol 2016; 14(1): e13468. https://doi.org/10.5812/iranjradiol.31007
Su Y, Wang C, Ye L. Healing rate and post-obturation pain of single- versus multiple-visit endodontic treatment for infected root canals: A systematic review. J Endod 2011; 37(2):125-132. https://doi.org/10.1016/j.joen.2010.09.005
Holland R, Gomes Filho JE, Cintra LTA, Queiroz IODA, Estrela C. Factors affecting the periapical healing process of endodontically treated teeth. J Appl Oral Sci 2017; 25(5):465-476. https://doi.org/10.1590/1678-7757-2016-0464
Kim YJA, Chandler NP. Determination of working length for teeth with wide or immature apices: A review. Int Endod J 2013; 46(6):483-491. https://doi.org/10.1111/iej.12032
Dalili Kajan Z, Taramsari M, Khosravi Fard N, Kanani M. Accuracy of cone-beam computed tomography in comparing with clearing and staining method in evaluating the root canal morphology: an in vitro study. Iran Endod J 2018; 13(2). https://doi.org/10.22037/iej.v13i2.18614
Abidi SYA, Azfar M, Nayab T, Shaukat A, Hasan M, Baig NN, et al. Accuracy of working length measurement with endo motor having built-in apex locator and comparison with periapical radiographs. JPMA J Pak Med Assoc 2020; 70(3):437-441. https://doi.org/10.5455/JPMA.302464
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. J Endod 2015; 41(11):1818-1823. https://doi.org/10.1016/j.joen.2015.08.012
Bhullar KK, Kaur R, Jossan AK, Malhotra S, Handa A, Bhagat G. Comparison of working length determination using cone-beam computed tomography, electronic apex locator and periapical radiograph in teeth with periapical lesion: An in-vivo study. Int J Health Sci 2022; 6(S4):4616-4625. https://doi.org/10.53730/ijhs.v6nS4.9141
Mahmoud O, Awad Abdelmagied MH, Dandashi AH, Jasim BN, Tawfik Kayali HA, Al Shehadat S. Comparative evaluation of accuracy of different apex locators: Propex IQ, Raypex 6, Root ZX, and Apex ID with CBCT and periapical radiograph - In vitro study. Int J Dent 2021; 2021:1-7. https://doi.org/10.1155/2021/5563426
Ustun Y, Aslan T, Sekerci AE, Sagsen B. Evaluation of the reliability of cone-beam computed tomography scanning and electronic apex locator measurements in working length determination of teeth with large periapical lesions. J Endod 2016; 42(9):1334-1337. https://doi.org/10.1016/j.joen.2016.06.010
Hotchandani SS, Harjani PR, Memon M, Kumar R, Kumar N, Rind SA. Comparative clinical assessment of working length endo- motor apex locator versus radiographic method in endodontic therapy. J Muhammad Med Coll 2021; 11(2):74-78. https://doi.org/10.62118/jmmc.v11i2.162
Mobarak EH, El-Badrawy W, Pashley DH, Jamjoom H. Effect of pretest storage conditions of extracted teeth on their dentin bond strengths. J Prosthet Dent 2010; 104(2):92-97. https://doi.org/10.1016/S0022-3913(10)60098-4
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