A Comparative Clinical Study of Digital Radiography, Electronic Apex Locator, and Cone-Beam Computed Tomography for Determining Root Canal Working Length

Abstract

Aim: The researcher used visual radiography, an electronic apex locator, and cone-beam computed tomography to determine and compare the precision of working length.

Materials and Methods: A total of 20 teeth which were indicated for extraction because of orthodontic reasons were selected for the study. Access cavity was prepared and the RVG (Radiovisuograph) working length (RVGWL) was determined by Ingles method.  A 15 no. K-file was advanced toward the apex until it reached a 0.5 mm short of the apex, as shown by the apex locator, for electronic root canal measurement (EAL)The tooth was atraumatically extracted and placed in an acrylic block after the file was fixed with a light cured composite. CBCT (Cone beam computed tomography) working length (CBCT WL) was measured and registered using a CARESTREAM CBCT scanner. The root canal and the tip of the file were then clear after apically grounding the tooth surface with a straight fissure diamond bur. With the aid of a stereomicroscope and a digital calliper, the gap between the file and the minor constriction was calculated and reported as the actual anatomical working duration (AAWL).

Statistical analysis: The one-way ANOVA test and Post hoc Tukey's test and Chi-square test were used for statistical analysis for this study.

Results: When mean working length was compared among different study groups using One way ANOVA, overall difference was not found to be statistically significant as p >0.05.

Pairwise comparison using Post hoc Tukey's test showed that none of the pair showed statistical significant difference as p<0.05.

Conclusion: There was no statistically significant difference in accuracy between RVG, EAL, and CBCT. Thus, understanding apical anatomy or curvature through the careful use of radiographs and the proper application of EAL can aid practitioners in achieving predictable results