Citation Information :
Goel T, Indushekar K, Saraf BG, Sheoran N, Sardana D, Chawla M. Comparative Evaluation of Working Length Using Conventional Radiographic Method, Radiovisiography, and Apex Locator in Single-rooted Permanent Teeth. J Oral Health Comm Dent 2021; 15 (2):49-54.
Introduction: The success of any root canal treatment depends on the accurate determination of the working length, biomechanical preparation, and obturation. Radiographs (conventional and radiovisiographs) have remained the mainstay modality in the determination of working length, although they are associated with disadvantages of high radiation exposure and increased treatment time. Apex locators are relatively regularly used equipment in working length determination, but their accuracy has been questioned time and again.
Aim and objective: The present study was done to evaluate and compare the accuracy of conventional radiographs, radiovisiographs (RVGs), and apex locators for the determination of working length.
Materials and methods: The present in vitro study was carried on 60 extracted single-rooted permanent teeth, and the working length was determined using three methods viz. conventional radiography, RVG, and apex locators. The three methods used were intercompared, and in addition comparison with actual working length of the tooth was also made.
Results: Among the three methods, the conventional radiographic method was found to be closest to the actual root canal length followed in order by RVG and electronic apex locator. Intercomparison between all three methods and actual root canal working length was found to be statistically significant except between conventional radiography and actual root canal working length. The difference between the mean values of root canal working length for conventional radiography and actual root canal working length was 0.01 mm, for RVG and actual root canal working length was 0.13 mm, and for electronic apex locator and actual root canal working length was 0.70 mm.
Conclusion: All the three methods for the determination of working length used in the study are clinically acceptable and are associated with advantages and disadvantages. Further research and advances may make electronic apex locator the technique of choice in working length determination, or a combination of the RVG and apex locator may be the future in endodontic therapy.
Ingle JI, Bakland LK. Endodontic cavity preparation. Textbook of endodontics. 5th ed. Philadelphia: BC Decker; 2002.
Vier-Pelisser FV, Meng A, Benedete Netto LC, et al. Influence of the instrumentation technique and apical preparation diameter on calcium hydroxide filling in simulated curved canals. Indian J Dent Res 2012;23(6):784–788. DOI: 10.4103/0970-9290.111260.
Dinapadu S, Pasari S, Admala SR, et al. Accuracy of electronic apex locator in enlarged root canals with different root canal irrigants: an in vitro study. J Contemp Dent Pract 2013;14(4):649–652. DOI: 10.5005/jp-journals-10024-1379.
Singh D, Tyagi SP, Gupta S, et al. Comparative evaluation of adequacy of final working length after using Raypex5 or radiography: an in vivo study. J Indian Soc Pedod Prevent Dent 2015;33(3):208. DOI: 10.4103/0970-4388.160363.
Mello I. Use of electronic apex locators may improve determination of working length. Evid Based Dent 2014;15(4):120. DOI: 10.1038/sj.ebd.6401066.
Alothmani OS, Friedlander LT, Chandler NP. Radiographic assessment of endodontic working length. Saudi Endod J 2013;3(2):57. DOI: 10.4103/1658-5984.118145.
Kishor KM. Comparison of working length determination using apex locator, conventional radiography and radiovisiography: an in vitro study. J Contemp Dent Pract 2012;13(4):550–553. DOI: 10.5005/jp-journals-10024-1184.
Er O, Uzun O, Ustun Y, et al. Effect of solvents on the accuracy of the Mini Root ZX apex locator. Int Endod J 2013;46(11):1088–1089. DOI: 10.1111/iej.12111.
Saatchi M, Iravani S, Khaleghi MA, et al. Influence of root canal curvature on the accuracy of root ZX electronic foramen locator: an in vitro study. Iran Endod J 2017;12(2):173. DOI: 10.22037/iej.2017.34.
Alothmani OS, Chandler NP, Friedlander LT. The anatomy of the root apex: a review and clinical considerations in endodontics. Saudi Endod J 2013;3(1):1. DOI: 10.4103/1658-5984.116273.
Mittal R, Singla MG, Sood A, et al. Comparative evaluation of working length determination by using conventional radiography, digital radiography and electronic apex locator. J Restorative Dent 2015;3(3):70. DOI:10.4103/2321-4619.168736.
Shearer AC, Horner K, Dutta K, et al. Comparative evaluation of three methods to measure working length: manual tactile sensation, digital radiograph, and multidetector computed tomography: an in vitro study. J Conserv Dent 2017;20(2):76. DOI: 10.4103/JCD.JCD_4_16.
Farida A, Maryam E, Ali M, et al. A comparison between conventional and digital radiography in root canal working length determination. Indian J Dent Res 2013;24(2):229. DOI: 10.4103/0970-9290.116693.
Kuştarci A, Arslan D, Altunbaş D. In vitro comparison of working length determination using three different electronic apex locators. Dent Res J 2014;11(5):568. PMID:25426148.
Kumar LV, Sreelakshmi N, Reddy ER, et al. Clinical evaluation of conventional radiography, radiovisiography, and an electronic apex locator in determining the working length in primary teeth. Pediatr Dent 2016;38(1):37–41. PMID:26892213.
Zand V, Rahimi S, Davoudi P, et al. Accuracy of working length determination using NovApex and Root-ZX apex locators: an in vitro study. J Contemp Dent Pract 2017;18(5):383. DOI: 10.5005/jp-journals-10024-2051.
Kokane VB, Patil SN, Gunwal MK, et al. Treatment of two canals in all mandibular incisor teeth in the same patient. Case Rep Dent 2014;2014. DOI: 10.1155/2014/893980.
Brito AC, Verner FS, Junqueira RB, et al. Detection of fractured endodontic instruments in root canals: comparison between different digital radiography systems and cone-beam computed tomography. J Endod 2017;43(4):544–549. DOI: 10.1016/j.joen.2016.11.017.