No abstract

Background: Accurate determination of the working length has a great impact on treatment prognosis. Apex locators have evolved to overcome the limitations of conventional radiography and increase the accuracy of working length determination. There is limited evidence about whether apex locators are actually superior to radiographic method. Aim: This study aims to review different clinical studies on the accuracy of apex locators in comparison to radiographic method for working length determination in permanent teeth. Methods: Clinical studies that compared apex locators to radiographic method were searched for in 3 databases including PubMed, Cochrane & Lilacs in addition to manual search to identify other potentially relevant articles. Nine articles were included in the study according to the inclusion criteria. Results: There is no significant difference between radiographic method and electronic apex locators in working length accuracy, obturation adequacy & Postoperative pain, however, there was a statistical significant difference between the two groups regarding the master cone accuracy in the favour of the radiographic method. Conclusion: Electronic apex locators are comparable in the accuracy of working length determination to radiographic method. However, electronic apex locators and digital radiographic methods were found to be beneficial from the perspective of radiation dose reduction.