Working Length Determination Research Articles

The effect of coronal pre-flaring and root canal irrigant on apex locators’ accuracy: an in-vitro study

Background: Successful root canal treatment is influenced by the apical extent of root canal preparation and the eventual root canal filling. Achieving the full working length until the apical constriction, which is usually 0.5 – 1 mm shorter than the anatomical apex, is crucial. Electronic apex locators were used to detect the working length more accurately. There are six generations of electronic apex locators in the market. The selection of the appropriate irrigation with each apex locator for accurate working length determination is not fully investigated. Methods: The actual working lengths of 120 freshly extracted human single-rooted teeth were measured and compared with their working lengths using 3rd generation (Root ZX) followed by 6th generation (Raypex 6) apex locators in dry medium, presence of 5.25% sodium hypochlorite, and 2% chlorhexidine, without coronal pre-flaring and after coronal pre-flaring using the same irrigating media. Data were collected, tabulated, and afterward analyzed using one-way ANOVA with post-hoc to evaluate the significant difference in average working length between actual working length, Root ZX, and Raypex 6 apex locator working lengths accuracy. Results: The significant results were shown in roots that were coronally pre-flared and their working lengths were measured in a dry medium using Raypex 6 apex locator. While using the Root ZX apex locator, the most accurate results were shown in roots that were coronally pre-flared and their working lengths were measured while using a chlorhexidine irrigating solution. Conclusions: It is concluded that it is very important to know the specific irrigating medium to be used with each specific electronic apex locator to achieve the most accurate working length results.

In Vitro Evaluation of the Accuracy of Three Electronic Apex Locators Using Different Sodium Hypochlorite Concentrations.

Background and Objectives: The aim of this study was to compare the accuracy of three types of electronic apex locators (EALs) when two different concentrations of NaOCl irrigation solutions are used by two operators. Materials and Methods: After creating the access cavities for 20 single rooted extracted teeth, the actual canal length (ACL) of each canal was determined visually using a #10 file and magnification. The teeth were subsequently inserted in plastic molds filled with alginate. The electronic measurement of root canal length (EWL) was performed using three different electronic apex locators: Root ZX II, Apex ID, and Dual Pex. Two independent operators, an endodontic specialist with 20 years practice and an undergraduate student in the final year of study, performed the irrigation procedures with two different concentrations of NaOCl (2% and 5.25%), and then measured the EWL using each of the EALs. The accuracy of all EALs, was determined in each case by subtracting the EWL from the ACL. Statistical analyses were performed using one-way ANOVA test. Results: In the presence of 2% NaOCl solution, for a margin error of ±0.5 mm, Root ZX II, Apex ID, and Dual Pex presented an accuracy of 90%, 80%, and 85% respectively. The increase in the concentration of the irrigation solution affected the accuracy of Root ZX II and Apex ID for both operators, diminishing it to 75% for the same margin error, but improved Dual Pex's accuracy to 100%. Conclusions: The best accuracy in working length determination was obtained by Root ZX II for 2% NaOCl solution and by Dual Pex for 5.25% NaOCl solution with no significant statistical difference when compared.

Students’ Experience, Self-Confidence, and Perception Toward Endodontic Learning: National Survey Among Malaysian Dental Schools

Objective: This study aimed to evaluate the first endodontic case experiences, self-confidence levels, and perceptions toward endodontic learning of final-year undergraduate students. Methods: An online questionnaire was emailed to 270 final-year dental students at 10 Malaysian dental schools. The questionnaire consists of 29 questions on students’ experience, self-confidence, and perception toward endodontic learning. Results: The response rate was 74.4%. The most frequently treated case was tooth diagnosed as nonvital associated with periapical periodontitis. Most of the students perceived working length determination as the most difficult stage and reported having low confidence in locating canal orifices in multirooted teeth and achieving satisfactory obturation. Overall, the students were satisfied with the endodontic knowledge taught by their respective faculties. Conclusion: Endodontic teaching in Malaysian dental schools was perceived as satisfactory by most dental students. Although endodontic treatment is perceived as difficult, students demonstrated high confidence in carrying out this treatment. However, they had limited ability in treating the complex root canal system.

Microbiological Effectiveness of Sodium Hypochlorite Gel and Aqueous Solution When Implemented for Root Canal Disinfection in Multirooted Teeth: A Randomized Clinical Study

The aim of endodontic therapy is to use various antimicrobial medications for proper cleaning and shaping to create an environment free of microorganisms by eradicating as many as possible from the root canal space. Even although it is a gold standard irrigant, sodium hypochlorite (NaOCl) is known for its cytotoxic effects on vital periapical tissues, making its higher concentrations inappropriate for use in conditions such as wide, underdeveloped, or damaged apices and in cases of perforations. Consequently, if it is ascertained that a gel form of sodium hypochlorite has equivalent antibacterial activity to the aqueous solution form, it could be employed in such situations. The aim of this study was the microbiologic evaluation of 5.25% sodium hypochlorite gel and aqueous solution as root canal disinfectants in multirooted teeth with primary endodontic lesions. Following ethical approval and CTRI registration, 42 patients who gave their consent and had multirooted teeth with pulpal necrosis and asymptomatic apical periodontitis were considered for the study. Following the opening of the access, pre-endodontic build up in case of class-II cavities and working length determination, a pre-operative sample (S1), which was regarded as the pre-operative microbial load of that canal, was acquired from the largest canal using a sterile paper point while maintaining strict isolation and disinfection. The computer randomization approach was used to divide the teeth into two groups at random just before beginning of chemo-mechanical preparation: Group A (n = 21)-canal disinfection with 5.25% sodium hypochlorite gel; Group B (n = 21)-canal disinfection with 5.25% sodium hypochlorite aqueous solution. Following the canal disinfection, a post-operative (S2) sample which was regarded as the postoperative microbial load of that canal was collected from the same canal using a sterile paper point. The Colony-Forming Units (CFUs) for the S1 and S2 samples were determined after 48 h aerobic incubation on Brain Heart Infusion (BHI) agar plates. The patients and the microbiologist were blinded throughout the procedure. Using SPSS 20.0 software (USA), the Shapiro-Wilk test and the Lilliefors Significance Correction were used for normality, followed by the Mann-Whitney U test which was used to compare the CFU difference (×105) between the two groups. A p value of <0.05 was perceived as statistically significant. The mean colony-forming units count difference between the 5.25% sodium hypochlorite gel and aqueous solution groups did not differ in a manner that was statistically significant (p = 0.744). In multirooted teeth with primary endodontic lesions, the 5.25% sodium hypochlorite gel and the aqueous solution demonstrated comparable antimicrobial effectiveness when implemented as root canal disinfectants.

In vitro evaluation of the accuracy of the fourth generation electronic apex locator: Apex ID

Background: To achieve success in endodontic treatment, the working length must be precisely defined and maintained during preparation. The introduction of the electronic apex locator makes it possible to determine the working length quickly and accurately. Apex ID is the 4th generation electronic apex locator, which can determine the working length in humid conditions. The objective of the study was to evaluate the accuracy of the Apex ID apex locator. Materials and methods: In vitro study on 50 orthodontic extracted mandibular premolars, measured working length by Apex ID apex locator. The measured value was compared with the actual length of the canal and the working length was determined by periapical X-ray. The accuracy of Apex ID was assessed through the distribution of measured values within an acceptable deviation of 0.5mm from the apical foramen. Result: The working length measured by the Apex ID machine was shorter than that measured by the periapical X-ray and the actual length of the canal (p&lt;0.05). Within the accuracy of ±0.5mm compared to the apical foramen, the working length measured by the apex locator had an accuracy of 90%, higher than that measured by the X-ray at the rate of 80% (p&lt;0.05). Conclusion: Apex ID apex locator has high accuracy, and can replace X-ray film in determining working length in clinical practice. Key words: working length, electronic apex locator, Apex ID, in vitro

Nationwide Trends of Modern Endodontic Practices Related to Working Length, Instrumentation, Magnification, and Obturation: A Comparative Cross-Sectional Survey Comparing Endodontic and Non-Endodontic Specialties Practicing Root Canal Treatment in India.

The present study was designed to assess trends in contemporary endodontic practice regarding the techniques and materials used in endodontic therapy among dental practitioners from various regions of India. A cross-sectional questionnaire-based study was conducted amongst dentists who were pursuing postgraduates in endodontics (PG Endo) and other branches (PG-OB), specialists from other branches (MDS-OB) and specialists in endodontics (MDS-Endo) in various dental colleges representing East, West, North, South, and Central zones through an e-survey using Google forms. State-wise postgraduate dental college lists were obtained from the Dental Council of India (DCI) website. Using a multistage cluster random sampling method and considering the unanticipated response rate, emails were sent to 2100. A 29-item close-ended questionnaire, framed according to different aspects of endodontic treatment, was used to record the responses. When the distribution of the groups of dentists was compared, the central zone had the highest number of PG-OB (44.2%) and the lowest number of MDS-Endo (8.4%). The electronic apex locator (EAL) method of working length determination has been reported less among MDS-Endo than MDS-OB. The difference between the usage of various methods for working length determination was significant among the different groups in all the zones. (p < 0.0001) Most MDS-Endo preferred the rotary method of instrumentation over the combination method for different zones. The majority of dental practitioners preferred a combination method of instrumentation. Zone-wise comparisons among dentists showed the majority of general dental practitioners preferred the combination method (radiographs and electronic apex locator) for working length determination. Most MDS-Endo preferred the rotary method of instrumentation over the combination method for different zones. All dental practitioners did not so commonly use magnification in all the zones. The single cone technique was the most opted by dental practitioners of all the zones.

Comparative ”ex vivo” study on working length determination using six apex locators

The aim of this study was to analyze the accuracy, precision, and consequently the reliability of five traditional apex locators (AL) and one integrated AL in determining working length (WL). Materials and Methods: The lengths of 15 extracted human teeth were measured with six ALs (Dentaport Root ZX, Dual Pex Micro Mega, Root ZX mini, Elements Diagnostic, Woodpex III, and E-connect S) and with digital radiographs (RVG). Electronic measurements were compared with each other and with radiographic measurements under the same experimental conditions. Results: Repeated measures ANOVA showed a significant difference between the radiographic and the electronic method. The Root ZX achieved the best accuracy and precision in determining the location of the apical foramen compared to other ALs. Conclusions: ALs are the most reliable method and superior to radiologic methods to determine the WL. Further studies should be performed to assess the differences between different types of ALs.

Artificial intelligence in endodontics: relevant trends and practical perspectives

Background. Overall pool of studies regarding artificial intelligence (AI) implementation in dentistry is increasing every year, while possibilities for using AI methods within everyday endodontic practice is still quite confined and not always enough affirmed. &#x0D; Objective. To systematize and depict principal data regarding use of virtual artificial intelligence for various endodontic-related clinical purposes.&#x0D; Materials and Methods. Targeted literature search was provided within National Center for Biotechnology Information databases using pre-specified Mesh-terms algorithm. The following information was extracted from each publication during content analysis: diagnostic and treatment planning aspects of endodontic practice for which AI methods could be applied; accuracy levels registered for AI models used for different endodontic-related purposes; limitations of using AI within endodontic practice.&#x0D; Results. AI features could be used in endodontic practice for the following reasons: analysis of root canal morphology, identification of root fractures, verification of periapical lesions, estimation of root canal working length, root canal treatment planning, prediction of pain development during post-treatment period, predication of endodontic interventions success. The most prevalently used artificial intelligence methods for different endodontic diagnostic and treatment planning objectives were the following: convolutional neural network, artificial neurons network, case-based reasoning, deep learning, machine learning, neuro-fuzzy inference system, probabilistic neural network.&#x0D; Conclusion. Main advantage of using AI models in endodontic practice associated with improvement of diagnostic accuracy within reduced amount of time needed for X-ray images and clinical data analysis. AI application for apical foramen detection and working length determination demonstrates the highest level of accuracy compared to AI performance for other clinically related objectives in endodontics.

Comparative evaluation of the quality and homogeneity of different obturating systems using cone-beam computed tomography - An in vitro study.

The aim of this study was to evaluate the homogeneity and quality of different obturating systems using cone-beam computed tomography (CBCT). One hundred and twenty extracted maxillary and mandibular molars were included in this study which was decoronated first and then dissected into palatal and distal roots. After working length determination, all the roots were biomechanically prepared with ProTaper universal system. The prepared roots were evaluated using CBCT, and volumetric analysis was done. Samples were then randomly divided into three groups corresponding to the obturation method used - cold lateral compaction technique, single-cone technique, and BeeFill 2 in 1 system. After obturation, CBCT imaging and volumetric analyses were performed again to compare and analyze the amount of volume of obturation in different obturating techniques. To standardize the volume, pre-and postobturation images were superimposed. To avoid errors, for each section, measurements were repeated three times and the means were calculated. The data were statistically analyzed using one-way analysis of variance, followed by post hoc test. Results showed a statistically significant difference of the single cone with lateral compaction and the BeeFill system (P < 0.001). Maximum volume of obturating material was found in BeeFill at all levels - Coronal, middle, and apical, followed by cold lateral compaction and single-cone technique (P < 0.001). It could be concluded that the thermoplasticized obturating technique can be a better choice for obturation rather than the single cone and lateral compaction technique.

Micro-CT evaluation of frozen and embalmed human cadavers on the effect of root canal preparation on microcrack formation in old dentin.

The aim of this study was to evaluate the existence of preoperative dentinal defects among differently preserved dentoalveolar bone-blocks (frozen vs. embalmed) and to investigate the effect of varying apical forces (low: <4 N, high: 4-8 N) during root canal preparation on microcrack formation using micro-computed tomography (micro-CT). Thirteen embalmed and seven frozen bone-blocks containing 1-3 single rooted teeth were collected. The teeth were evenly divided into three groups (n = 10): FLow (frozen, <4 N), ELow (embalmed, <4 N), EHigh (embalmed, 4-8 N). After working length determination all specimens were scanned preoperatively. Root canal preparation was performed using nickel-titanium instruments sizes 25/.06 and 40/.06 (F6 SkyTaper; Komet, Lemgo, Germany). A postoperative scan was performed and image stacks were co-registered. All cross-sectional images were screened to identify the presence of dentinal defects. The results were expressed as the percentage of teeth/slices presenting dentinal defects. The statistical analyses were performed with Kruskal-Wallis-Test and Mann-Whitney-U-Test (α = 5%). Embalmed specimens presented a significantly higher percentage of slices with preoperative microcracks (p<0.05) than frozen specimens. No significant difference between groups was observed regarding the induction of microcracks (p>0.05). Root canal preparation does not induce microcracks in dentoalveolar bone-blocks from donors of old age, irrespective of the preservation method and the apically directed forces.

Developments and Performance of Artificial Intelligence Models Designed for Application in Endodontics: A Systematic Review.

Technological advancements in health sciences have led to enormous developments in artificial intelligence (AI) models designed for application in health sectors. This article aimed at reporting on the application and performances of AI models that have been designed for application in endodontics. Renowned online databases, primarily PubMed, Scopus, Web of Science, Embase, and Cochrane and secondarily Google Scholar and the Saudi Digital Library, were accessed for articles relevant to the research question that were published from 1 January 2000 to 30 November 2022. In the last 5 years, there has been a significant increase in the number of articles reporting on AI models applied for endodontics. AI models have been developed for determining working length, vertical root fractures, root canal failures, root morphology, and thrust force and torque in canal preparation; detecting pulpal diseases; detecting and diagnosing periapical lesions; predicting postoperative pain, curative effect after treatment, and case difficulty; and segmenting pulp cavities. Most of the included studies (n = 21) were developed using convolutional neural networks. Among the included studies. datasets that were used were mostly cone-beam computed tomography images, followed by periapical radiographs and panoramic radiographs. Thirty-seven original research articles that fulfilled the eligibility criteria were critically assessed in accordance with QUADAS-2 guidelines, which revealed a low risk of bias in the patient selection domain in most of the studies (risk of bias: 90%; applicability: 70%). The certainty of the evidence was assessed using the GRADE approach. These models can be used as supplementary tools in clinical practice in order to expedite the clinical decision-making process and enhance the treatment modality and clinical operation.

Accuracy of the electronic apex locator, tactile, and radiographic methods in working length determination.

Determination of working length (WL) is necessary for the successful outcome of root canal treatment (RCT). Common methods in WL determination include tactile, radiographic, and electronic apex locators (EAL). The aim of this study was to compare three methods of WL determination to the actual visualization of the apical constriction (AC). Consecutive patients with indications for extraction of single-rooted single canal teeth at the University of Ghana Dental School clinic were randomly assigned to three groups. In-vivo root canal WL was determined by tactile sensation, digital radiography, and a 5th generation EAL (Sendoline S5). Files were cemented in the canals after the in-vivo measurements. The apical 4-5 mm of the roots was trimmed to expose the inserted files and the AC. Actual WL, as determined by visualization of the AC, was done using a digital microscope. Different WLs were then compared for the various groups, and the mean actual canal lengths were reported. EAL accurately predicted the AC in 31 (96.9%) teeth, while the digital radiographic and tactile sensation methods accurately predicted the constriction in 19 (59.4%) and 8 (25%) teeth, respectively, in the study population. The mean working canal lengths for single-rooted teeth showed no observable difference among sexes, age categories, and side of the jaw. The EAL provided more reliable and accurate WL measurements for single-rooted teeth among Ghanaians, compared to digital radiography and tactile methods.

How comparable is electronic to radiographic method in working length determination during endodontic treatment?

How comparable is electronic to radiographic method in working length determination during endodontic treatment?

Evaluation of the Diagnostic and Prognostic Accuracy of Artificial Intelligence in Endodontic Dentistry: A Comprehensive Review of Literature.

This comprehensive review is aimed at evaluating the diagnostic and prognostic accuracy of artificial intelligence in endodontic dentistry. Artificial intelligence (AI) is a relatively new technology that has widespread use in dentistry. The AI technologies have primarily been used in dentistry to diagnose dental diseases, plan treatment, make clinical decisions, and predict the prognosis. AI models like convolutional neural networks (CNN) and artificial neural networks (ANN) have been used in endodontics to study root canal system anatomy, determine working length measurements, detect periapical lesions and root fractures, predict the success of retreatment procedures, and predict the viability of dental pulp stem cells. Methodology. The literature was searched in electronic databases such as Google Scholar, Medline, PubMed, Embase, Web of Science, and Scopus, published over the last four decades (January 1980 to September 15, 2021) by using keywords such as artificial intelligence, machine learning, deep learning, application, endodontics, and dentistry. The preliminary search yielded 2560 articles relevant enough to the paper's purpose. A total of 88 articles met the eligibility criteria. The majority of research on AI application in endodontics has concentrated on tracing apical foramen, verifying the working length, projection of periapical pathologies, root morphologies, and retreatment predictions and discovering the vertical root fractures. In endodontics, AI displayed accuracy in terms of diagnostic and prognostic evaluations. The use of AI can help enhance the treatment plan, which in turn can lead to an increase in the success rate of endodontic treatment outcomes. The AI is used extensively in endodontics and could help in clinical applications, such as detecting root fractures, periapical pathologies, determining working length, tracing apical foramen, the morphology of root, and disease prediction.

Comparison of working length determination with four electronic apex locators

Comparison of working length determination with four electronic apex locators

Comparative analysis of root canal length determination using cone-beam computerized tomography and apex locator

Introduction. Determining the length of the root canal is one of the key factors that can affect the outcome of endodontic therapy. Incorrectly determined working length results in underfilled or overfilled canal. The aim of this work was to verify the effectiveness of cone-beam computerized tomography (CBCT) and apex locators in determining working length of the root canal. Material and method. Endodontic procedure was performed according to established endodontic protocol on 98 teeth. Teeth were divided into two groups: single-rooted and multi-rooted teeth. In both groups, working length was measured with an apex locator (Woodpex III) and CBCT (Planmeca Viso). In multi-rooted teeth, the canals were classified according to their morphological position into the groups Lingvomesial (LM), Buccomesial (BM), Bucodistal (BD), Palatal (P) and Distal (D) canals. Root canal length was determined by a dentist using apex locator at the University of Banja Luka while CBCT analysis was performed by a radiology engineer at the 3DENT radiology center in Banja Luka. Results. CBCT odontometry had small deviations from apex locator odontometry. The mean value of the absolute difference between CBCT measurement and apex locator measurement was the smallest in the group of linguomesial canals (0.284 mm), and the largest in the group of distal canals of the lower molars (1.939 mm). Based on the results of the Mann-Whitney U test, it was concluded that there was no statistically significant difference (p &gt; 0.05) in measured length of the root canal between the two methods in all groups of roots of multi-rooted teeth as well as in the group of single-rooted teeth. Conclusion. CBCT odontometry is as reliable as apex locator odontometry.

Comparative assessment of cleaning efficacy of Kedo-SH manual and Kedo-S rotary endodontic files in deciduous molars - an in-vitro study

Introduction: Preparation of root canals in deciduous molars can be challenging due to their inherent anatomy. Endodontic files were introduced recently for exclusive use in deciduous dentition. Hence, the aim of the present comparative study was to assess the cleaning efficacy of manual and rotary endodontic files in deciduous molars. Methods and materials: Sixty canals of recently extracted deciduous molars were selected which did not have more than one-third of their root length resorbed. Following working length determination, India ink dye was injected into all the canals. They were arbitrarily allocated into two groups; Group I: Kedo-SH manual files (n=30) and Group II: Kedo-S rotary files (n=30), for the purpose of instrumentation. The root canals were cleared of debris and sections prepared. The sections were examined under a stereomicroscope under 40X magnification for removal of India ink at different thirds and given scores. Data was subjected to statistical analysis using Student t test and ANOVA. Level of significance was 5%. Results: Both file systems resulted in superior cleaning of the coronal and apical section of the canals. The average scores for coronal and middle sections of the root canals with Kedo-SH manual files (9.5 ± 8.062; 10.75 ± 10.31, respectively) were significantly higher than that of Kedo-S rotary files (5± 6.63; 6.05 ±7.5, respectively) (p&lt;0.05). Conclusion: Root canals prepared with Kedo-S rotary files showed significant superiorly clean root canals than those prepared using Kedo-SH manual files. Keywords: Kedo-S, Kedo-SH files, deciduous molars, pulpectomy, root canal instrumentation.

COMPARISON OF THE METHOD OF ELECTROMETRIC DETERMINATION OF ROOT CANAL PARAMETERS AND THE METHOD OF THRESHOLD SEGMENTATION OF RADIOGRAPHS

The subject matter of the article is X-ray images of teeth during endodontic operations. The goal of the work is to compare the developed method of segmentation of the radiograph to determine the length of the root canal with the electrometric and mathematical methods in practice. The article uses the following methods: principles of endodontic preparation of teeth; methods of determining the working length of the root canal (radiological, electrometric); threshold segmentation method; method of segmentation of bone structures on tomographic images. The following results were obtained: the existing methods of determining the working length of the root canal were analyzed, the main advantages and disadvantages of each method were highlighted. The mathematical method is fast, but inaccurate and can only serve as a preliminary estimate. Electrometric is the most accurate, but has very strict requirements for measurement in the area of canal moisture, as well as invasiveness of the method has a number of disadvantages. Radiological is the most promising for research because of its painlessness to the patient, low radiation dose during intraoral radiography and the possibility of using image processing algorithms to refine the measurement results. This work formulated principles for segmentation and extraction of tooth contours on the X-ray image to determine working length and conducted practical studies to compare all methods of analysis. Conclusions. The application of the electrometric length determination method gives the most accurate result, but the segmentation of the radiograph allows the doctor to obtain additional information about the architectonics of the root canal. As well as the possibility of using image processing such as segmentation, contour extraction and automatic determination of the apical constriction zone make this method the most perspective. The most optimal is the combination of these two methods in practice, which requires additional research.

Effect of Preflaring on Accuracy of Endodontic Length Determination by Four Electronic Apex Locators

Objective: Root canal anatomy significantly impacts the working length determination. This study aimed to investigate the effect of the preflaring technique on the accuracy of four electronic apex locators. Methods: Forty-five single-canal central maxillary teeth were selected. The working length was measured before and after the coronal preparation by four types of electronic apex locators in the range of ±0.5 and ±1 mm matched for the apical constriction. The actual working length was calculated under a microscope. Data were analyzed using ICC and paired t-tests in SPSS16. A p &lt; 0.05 was considered significant. Results: The accuracies of Root ZX, DTE, Denjoy, and Coxo apex locators in the range of ± 0.05 mm were 71.1, 93.3, 84.4, and 75.6% before preflaring, and 82.2, 93.3, 97.8, and 100% after that. The corresponding values in the range of ±1 mm were 86.7, 97.8, 93.3, and 100% before and 97.8, 100, 100, and 100% after preflaring. Significant differences were found between the working lengths measured by the four devices and the actual working lengths before and after preflaring. Conclusion: The preflaring technique could impact the performance of apex locators in determining the working length and may be advocated for better outcomes.

Reliability of CBCT in working length determination for successful endodontic treatment- an in vitro study

Aim: To evaluate and compare the accuracy of working length determination using Radiovisiography, Cone Beam Computed Tomography and Actual working length of the tooth. Material and Methods: After the access cavity preparation in seventy- two extracted human single rooted teeth, the working length was measured, using Radiovisiography and Cone beam Computed Tomography and its accuracy was compared with the actual working length of the teeth using surgical loupes. Unpaired ‘t’ test was used to test the significance of difference observed in mean working length measurements. Results:. The difference in distribution of readings was found insignificant (p&lt;0.75) by Chi square analysis. The result showed that cone beam computed tomography working length had high percentage of accurate readings as compared to radiographic working length readings. The results also showed high Karl Pearson’s correlation coefficient between the actual working length, radiographic and CBCT working length. Conclusions: Cone beam computed tomography (CBCT) imaging is as accurate and valuable adjunct as the actual working length in determining working length. Clinical Significance: Considering the availability of CBCT and its wide implication in endodontics, there is a need to explore if CBCT can be used as a tool at par with the actual working length determination in endodontics.