Aims:The purpose of this in vitro study was to compare the root canal length determination by Electronic apex locator (EAL) (Raypex 5) and conventional radiography, and then compare them with the actual measurements obtained by direct visualization.Settings and Design:This study was conducted at the Department of Pedodontics and Preventive Dentistry, Government Dental College, Thiruvananthapuram, Kerala, India.Subjects and Methods:One hundred single rooted primary teeth extracted due to extensive caries, trauma, serial extraction or unwillingness of the parent to save the teeth were selected. The teeth were numbered and root canal length was determined using the visual, electronic and the radiographic methods. The actual, electronic and the radiographic measurements were recorded.Statistical Analysis Used:Data were analyzed using Intraclass correlation test and linear regression analysis.Results:The accuracy of EAL and radiographic methods were 92% and 72%, respectively within + 0.5 mm. Both the electronic and conventional radiographic methods showed a high correlation and agreement (ICC intraclass correlation coefficient = 0.99 and 0.98 respectively) with the actual measurements.Conclusions:EALs proved to be more accurate in determining the root canal length than the radiographic method.

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Diagnosis forms the backbone of treatment planning. Accurate diagnosis is essential to initiate the appropriate treatment at the apt time. Diagnosis involves eliciting the signs and symptoms of the patient and their accurate interpretations. The subtle signs that can go unnoticed lead to misdiagnosis and subsequent agony to the patient. Alertness on part of the clinician is important to avoid this error. Reported in this paper are four cases that were wrongly diagnosed either due to lack of clinical experience or due to omission of careful clinical, radiographic, and histopathological examinations.