Accuracy of Working Length Determination in Root Canal Treatment Using Different Algorithms

Successful root canal treatment depends on thorough cleaning & shaping and 3- dimensional fluid impervious obturation of tooth within the confines of canals. To achieve this objective the apical constriction must be detected accurately during canal preparation and precise control over working length during the procedure must be maintained. There are many methods of working length determination including radigraphs and electronic method(apex locator). Introduction of apex locators have definitely served as an effective adjuvant to radiographs.

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Root canal curvature as a prognostic factor influencing the diagnostic accuracy of radiographic working length determination and postoperative canal axis modification: an in vitro comparative study

BMC Oral Health ◽

10.1186/s12903-021-01446-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bestoon Mohammed Faraj

Keyword(s):

Root Canal ◽

Radiographic Images ◽

The Real ◽

Root Canals ◽

Length Estimation ◽

Working Length ◽

Length Determination ◽

Case Difficulty Assessment ◽

The Impact

Abstract Background Radiographic analysis of tooth morphology is mandatory for accurate calibration of the degree of canal curvature angle and radiographic working length to its real dimensions in case difficulty assessment protocols. This study aimed to determine the impact of the degree of root canal curvature angle on maintaining the real working length and the original canal axis of prepared root canals using a reciprocating rotary instrumentation technique. Methods Radiographic image analysis was performed on 60 extracted single-rooted human premolar teeth with a moderate canal curvature (10°–25°) and severe canal curvature (26°–70°). Working length and longitudinal canal axis were determined using cone-beam computed tomography (CBCT) and digital periapical radiography. The real canal length was determined by subtracting 0.5 mm from the actual canal length. Root canals were prepared using the WaveOne Gold reciprocating file (Dentsply Maillefer, Ballaigues, Switzerland). Results There was no significant relation of the degree of canal curvature angle to the accuracy of radiographic working length estimated on CBCT and digital periapical radiographic techniques (P > 0.05). Postinstrumentation changes in the original canal axis between moderate and severe canal curvature angles, assessed on CBCT and periapical digital radiographic images were statistically non-significant (P > 0.05). Conclusions A standardized digital periapical radiographic method performed similarly to the CBCT technique near to its true working length. No significant interaction exists between the diagnostic working length estimation, postoperative root canal axis modification, and the degree of canal curvature angle, using reciprocating rotary instrumentation technique.

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Tactile working length determination for root canal therapy in underserved settings

Evidence-Based Dentistry ◽

10.1038/sj.ebd.6401029 ◽

2014 ◽

Vol 15 (2) ◽

pp. 56-57 ◽

Cited By ~ 1

Author(s):

Abdullah J Dohaithem ◽

Eman O Bakarman ◽

Analia Veitz-Keenan

Keyword(s):

Root Canal ◽

Root Canal Therapy ◽

Working Length ◽

Length Determination

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A Survey of Standard Protocols for Endodontic Treatment in North of KSA

ISRN Dentistry ◽

10.1155/2014/865780 ◽

2014 ◽

Vol 2014 ◽

pp. 1-4 ◽

Cited By ~ 4

Author(s):

Azhar Iqbal ◽

Iftikhar Akbar ◽

Beenish Qureshi ◽

Mohd G. Sghaireen ◽

Mahmoud K. AL-Omiri

Keyword(s):

Saudi Arabia ◽

Root Canal ◽

Computer Software ◽

Endodontic Treatment ◽

Preparation Technique ◽

Gutta Percha ◽

Working Length ◽

True Representation ◽

Length Determination ◽

General Dentists

The objective of this study was to collect information regarding methods, materials, and attitudes employed during the endodontic treatment by dentists in north of Saudi Arabia. A questionnaire was designed and distributed among 300 dentists in north of Saudi Arabia to collect the data about the standard protocols of endodontic treatment. The collected data was analyzed by using the SPSS 10 computer software. Out of a total of 300 surveyed dentists, the 66% response rate showed that this study was true representation of the endodontic treatment performed by the dentists in north of Saudi Arabia. 152 (76%) were general dentists and 48 (24%) were endodontists. 18 (9%) were using rubber dam as the method of isolation during endodontic treatment. 173 (86.5%) were using only measurement radiographs for working length determination and 27 (13.5%) were using both electronic apex locator and measurement radiographs. 95 (47.5%) of the respondents were using standardized technique and 25 (12.5%) were using step-down as a root canal preparation technique. 127 (63.5%) of the respondents were using lateral condensation technique, with gutta percha points for root canal obturation.

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In vivo accuracy of conventional and digital radiographic methods in confirming root canal working length determination by Root ZX

Journal of Applied Oral Science ◽

10.1590/s1678-77572012000500005 ◽

2012 ◽

Vol 20 (5) ◽

pp. 522-525 ◽

Cited By ~ 5

Author(s):

Fernando Accorsi Orosco ◽

Norberti Bernardineli ◽

Roberto Brandão Garcia ◽

Clovis Monteiro Bramante ◽

Marco Antonio Húngaro Duarte ◽

...

Keyword(s):

Root Canal ◽

Working Length ◽

Length Determination

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Radiographic versus electronic root canal working length determination

Indian Journal of Dental Research ◽

10.4103/0970-9290.94666 ◽

2011 ◽

Vol 22 (6) ◽

pp. 777 ◽

Cited By ~ 2

Author(s):

Lumnije Kqiku ◽

Peter Städtler

Keyword(s):

Root Canal ◽

Working Length ◽

Length Determination

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A comparison between conventional and digital radiography in root canal working length determination

Indian Journal of Dental Research ◽

10.4103/0970-9290.116693 ◽

2013 ◽

Vol 24 (2) ◽

pp. 229 ◽

Cited By ~ 3

Author(s):

Ehsani Maryam ◽

Mirzapour Ali ◽

Moudi Ehsan ◽

Yousefi Sajad ◽

Khafri Soraya ◽

...

Keyword(s):

Digital Radiography ◽

Root Canal ◽

Working Length ◽

Length Determination

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Accuracy of Working Length Measured by Apex Locator and Digital Radiography

Journal of The Pakistan Dental Association ◽

10.25301/jpda.301.24 ◽

2021 ◽

Vol 30 (1) ◽

pp. 24-28

Author(s):

Ghulam Ishaq Khan ◽

◽

Muhammad Talha Khan ◽

Saroosh Ehsan ◽

Anam Fayyaz ◽

...

Keyword(s):

Digital Radiography ◽

Root Canal ◽

Reference Points ◽

Radiographic Measurement ◽

Apical Constriction ◽

Actual Length ◽

Actual Working ◽

Working Length ◽

Length Determination ◽

Electronic Apex Locator

OBJECTIVE: The objective of this study was to compare the measurements of electronic and radiographic method of working lengths calculation with actual working length of root canals. Precise working length determination is the most important part for successful root canal procedure. The most commonly used methods to determine the working length in root canal treatment are radiography and electronic apex locator. METHODOLOGY: A cross sectional study was done over a period of 06 months in the Department of Operative Dentistry, Fatima Memorial Hospital, Lahore. Sixty patients who were recommended extraction of their premolar teeth with sixty canals were selected by convenience sampling. The Root ZX* apex locator was used to determine electronic working length exactly identifying the apical constriction. Reference points were identified and radiographic working length were determined 1mm short of radiographic apex. The teeth were extracted along with file cemented before extraction inside root canal. The actual length of the root canal was then calculated using the same files and reference point with 3.5X magnification. Pearson chi square test was applied to compare the apex locator and digital radiographic measurement with actual working length. RESULTS: The Root ZX® apex locator was 95% accurate to identify the apical constriction as compared 70% accuracy given by radiographs within 0.5 mm of the apex. CONCLUSION: Electronic apex locator was more accurate as compared to digital radiography in working length determination. KEYWORDS: Working length (WL), Electronic apex locators (EAL), Radiographic working length(RWL), Apical constriction (AC) HOW TO CITE: Khan GI, Khan MT, Ehsan S, Fayyaz A, Malik HA, Hussain S. Accuracy of working length measured by apex locator and digital radiography. J Pak Dent Assoc 2021;30(1):24-28.

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