The use of radiography and the apex locator in endodontic treatment within the UK: a comparison between endodontic specialists and general dental practitioners

Abstract

To investigate the attitudes of general dental practitioners (GDPs) and specialist endodontists working in the UK in the use of radiography and apex locators during root canal treatment and to see if use was related to respondent's age and the year of graduation. A postal questionnaire was sent to 857 randomly selected GDPs and all endodontic specialists working in the UK (170). Non-responders were sent a further two mailings. Chi-squared tests were used to compare both groups at the P < 0.05 level of significance. For nonparametric data, the Mann-Whitney U test was employed. The overall response rate was 73%. There were significant differences between endodontic specialists and GDPs in the prescription of the preoperative, the cone-fit and the postoperative radiograph. A total of 114 (86.4%) endodontic specialists and 321 (53.2%) GDPs reported using an apex locator (P < 0.001). Eighty-eight (66.7%) endodontists and 217 (36%) GDPs used an apex locator and a radiograph to determine the working length for a single-rooted tooth (P < 0.001). For multi-rooted teeth, 91 (68.9%) endodontists and 229 (38%) GDPs used a combined approach of an electronic apex locator and a working-length radiograph (P < 0.001). One-millimetre short of the radiographic apex was employed by 56.2% of respondents as the apical limit. There were significant differences (P < 0.001) between the two groups with regard to routine radiographic follow-up. Both endodontists and GDPs were found to be observing national guidelines when performing root canal treatment. Greater use of apex locators was found amongst endodontists who tended to use a combined approach of an apex locator and periapical radiography.