Modified Bisecting Angle Technique: A Novel Method to Eliminate Zygomatic Superimposition over the Apices of Maxillary Molars

Abstract

Objectives: Intra oral radiographic imaging is the most widely used method for obtaining information about root canal anatomy and working length determination. Measuring exact working length is the most essential step for the success of root canal treatment. Bisecting angle technique (BAT) is the most widely used technique for this purpose. However, zygomatic superimposition over the apices of maxillary molars makes it difficult for the dentist to estimate exact working length. The present study made certain modifications in BAT to overcome these undiagnostic shadows. The aim of the study is to compare three techniques, namely paralleling cone technique (PCT), BAT and modified bisecting angle technique (MBAT) to prevent such superimposition over molar apices. Materials and Methods: A total of 53 patients requiring endodontic treatment for maxillary molars were included in the study. Three radiographs one with each PCT, BAT, MBAT were made. Each radiographic image was recorded acceptable or unacceptable based on the zygomatic superimposition. The data thus collected was subjected to statistical analysis using chi-square test. Results: The percentage of acceptability in MBAT was 56.6% (n = 30) when compared with BAT which was only 28.3% (n = 15) and PCT was 58.3% (n = 31) indicating statistically significant difference between BAT and MBAT. But no statistically significant difference was found between MBAT and PCT. Conclusion: In the present study, MBAT was found to be more accurate than BAT, and it was relatively as accurate as PCT in eliminating zygomatic superimposition over the apices of maxillary molars.