Preoperative Estimation of Endodontic Working Length with Cone-Beam Computed Tomography and Standardized Paralleling Technique in comparison to Its Real Length.

Bestoon Mohammed Faraj,Cristiana Corsi

doi:10.1155/2020/7890127

Abstract

An accurate estimation of the working canal length is essential for successful root canal treatment. This study is aimed at investigating the diagnostic accuracy of root canal length estimation on cone-beam computed tomography (CBCT) scans and digital paralleling radiographs (PAs), using the real canal length as a gold standard, and at evaluating the influence of canal curvature on this estimation. Sixty extracted human premolar teeth were selected for this study. Root canal length measurement was performed on CBCT scans (NewTom, Giano, Verona, Italy) and digital paralleling radiography (EzRay Air W; Vatech, Korea). The real working length was established by subtracting 0.5 mm from the actual canal length. No significant difference was found between CBCT and digital paralleling radiography. There was a tendency for underestimation of the root canal length measured on the CBCT images in 52 (86.7%) of the examined teeth and overestimation in 5 teeth (8.3%). All the digital radiographs slightly overestimated the real canal length. The analysis revealed a strong correlation between the estimation from moderate to severe curvature for digital radiography and CBCT images. Preoperative working length estimation can be made closest to its real clinical canal length on the standardized paralleling technique, using a long (16-inch) target-receptor distance.

Highlights

Radiographic working length estimation is an essential component of the overall endodontic diagnosis and treatment planning process
A comparison of mean values of estimated canal length assessed using three methods depending on the degree of canal curvature is summarized in (Tables 1 and 2)
There was a tendency for underestimation of the root canal length measured on the cone-beam computed tomography (CBCT) images in comparison with the real root canal length from -1.2 mm to -0.1 mm

Summary

Introduction

Radiographic working length estimation is an essential component of the overall endodontic diagnosis and treatment planning process. Conventional 2-dimensional (2D) radiographs provide a cost-effective, high-resolution image, which continues to be the most popular method of imaging today. Magnification, and superimposition may negatively affect the determination of the accurate working length [3]. Periapical radiography fails to provide an accurate location of the apex in cases in which an eccentric apical foramen is present [4]. Radiographic imaging is the most commonly used diagnostic tool in endodontic diagnosis and treatment planning. Accuracy of the working length plays a crucial role in determining the success of root canal treatment and could be a predictor of success and possible complications [5]. Overestimation of the endodontic working length may cause overinstrumentation of the root canals, whereas underestimation of the working length may result in insufficient root canal preparation [6, 7]

Objectives

Methods

Results

Conclusion