In Vitro Comparison of the Accuracy of Cone-Beam Computed Tomography Scanning and Electronic Apex Locators in Detection of Simulated Root Perforations in Different Localizations

Abstract

IntroductionThis study aimed to compare the accuracy of cone-beam computed tomographic (CBCT) scanning and 2 different electronic apex locators (EALs) in the detection of simulated root canal perforations in different localizations. MethodsEighty human mandibular premolars were prepared and divided into 2 groups according to the localization of the perforation area, having a 1-mm diameter. The distance between the occlusal edge and the beginning of the perforation was measured under a stereomicroscope (actual working length) using 2 EALs (Propex II [Dentsply Maillefer, Ballaigues, Switzerland] and Dentaport ZX [J. Morita, Tokyo, Japan]) (electronic working length) and CBCT images (CBCT working length). The calculations were made by subtracting the actual working length from the electronic working length and the CBCT working length to determine the differences. ResultsIn the apical third perforation group, there was a significant difference between Dentaport ZX and CBCT imaging. There was no significant difference between Dentaport ZX and Propex II and Propex II and CBCT measurements. In the middle third perforation group, Propex II was significantly more successful than CBCT imaging. In addition, there was no significance between the accuracy of Propex II in detecting the perforation area between the apical third perforation group and the middle third perforation group. CBCT imaging was more accurate in detecting the perforation area in the apical third perforation group than in the middle third perforation group. ConclusionsIn cases in which the root canal perforation was in the apical third of the root, both the EAL and CBCT imaging were successful in determining the perforation area, whereas the success rate of all devices used in this study decreased when the perforation area was in the middle third of the root.