Abstract
BackgroundObtaining a correct working length is critical to the success of endodontic therapy. Different methods have been used to identify this crucial measurement. The Aim of this clinical study was to compare the effect of working length determination using apex locator alone or in combination with working length radiograph on the apical extent of root canal filling.MethodsA total number of 66 patients, 151 canals were randomized into two groups, In group (I) working length was determined by apex locator alone, while in group (II) working length was determined by apex locator confirmed by working length radiograph, length of obturation was assessed, and the total number of radiographs was recorded. The data were analyzed using SAS system and T. tests were carried out. Statistical significance was considered to be P ≤ 0.05.ResultsSixty seven canals in group I were treated with a mean distance from the tip of root canal filling to radiographic apex -0.5 mm ± 0.5 and a mean of a total number of radiographs of 2.0, while in group II eighty four canals were treated with a mean distance from the tip of root canal filling to radiographic apex -0.4 mm ± 0.5 and a mean of a total number of radiographs of 3.2. There was no statistically significant difference in the mean distance from the tip of root filling to radiographic apex between group I and group II (P > 0.05).ConclusionThe practice of using electronic apex locator in the determination of working length is useful and reliable with no statistical difference of the radiographic extent of root canal filling when using apex locator alone or in combination with working length radiograph. Under the clinical conditions of this study, it is suggested that the correct use of an apex locator alone could prevent the need for further diagnostic radiographs for determination of working length. This method can be useful in patients who need not to be exposed to repeated radiation because of mental, medical or oral conditions.
Highlights
Obtaining a correct working length is critical to the success of endodontic therapy
A total of 67 canals in group I, in which an apex locator was used without a radiograph, showed a mean distance from the tip of root canal filling to radiographic apex of 0.5 mm and a mean of a total number of radiographs of only 2.0 was needed
While in group II, in which an apex locator was used in conjunction to a radiograph, a total of 84 canals showed a mean distance from the tip of root canal filling to radiographic apex -0.4 mm and a mean of a total number of radiographs of only 3.2, including a preoperative and a postoperative radiographs, was needed
Summary
Obtaining a correct working length is critical to the success of endodontic therapy. Different methods have been used to identify this crucial measurement. The Aim of this clinical study was to compare the effect of working length determination using apex locator alone or in combination with working length radiograph on the apical extent of root canal filling. The main shortcoming of early apex locators (erroneous reading with electrolytes) [5] was overcome by Kobayashi 1991 [6] with the introduction of ratio method. In this method two electric currents with different sine wave frequencies will have measurable impedances that can be measured and compared as a ratio regardless of the type of electrolyte in the canal. The Tri auto ZX has a reported accuracy similar to Root ZX of 95% [10] with the addition of some safety features such as auto-reverse when working length is reached [11]
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