Accuracy of Three Types of Apex Locators versus Digital Periapical Radiography for Working Length Determination in Maxillary Premolars: An In Vitro Study

Abstract

This study aimed to compare the accuracy of three types of apex locators versus digital radiography for working length (WL) determination. This experimental study was conducted on 58 extracted maxillary premolars. The teeth were decoronated, the access cavity was prepared, and WL was determined using a #15 K-file to serve as reference. The WL was then measured by Woodpex V, Woodpex III, and Root ZX apex locators in the presence of 0.9% saline, and also on a photostimulable phosphor plate (PSP) digital radiograph taken by the parallel technique. The values were compared with the actual WL using the paired t-test (alpha = 0.05). Digital radiography, Root ZX, Woodpex V, and Woodpex III determined the WL within ±0.5 mm from the actual value in 84.48%, 100%, 89.66%, and 87.93% of the cases, respectively. Woodpex V (p = 0.039), Woodpex III (p = 0.001), and Root ZX (p = 0.001) significantly over-estimated the WL. The WL measured on digital radiographs was not significantly different from the actual WL (p = 0.213). The position of the apical foramen (central/lateral) had no significant effect on the accuracy of WL determination by different techniques (p >0.05). Within the limitations of this in vitro study, all the tested modalities showed acceptable accuracy for WL determination in maxillary premolars.

Accuracy of the electronic method versus the radiographic method in determining working length: integrative systematic review

“…After thoroughly reading and analysing each article, 15 articles were excluded because their study objective was methods other than periapical radiography (conventional or digital) and LEAs, leaving 11 articles for inclusion in this systematic review (Chaudhary et al, 2018;Keratiotis et al, 2019;Khandewal et al, 2015;Khursheed et al, 2014;Mahmoud et al, 2021;Pishipati, 2013;Raghu et al, 2014;Rambabu et al, 2018;Ramezani et al, 2022;Shah et al, 2013;Tampelini et al, 2017).…”

“…Após a leitura completa e análise minuciosa de cada artigo, 15 artigos foram excluídos pois tinham como objetivo de estudo métodos que não a radiografia periapical (convencional ou digital) e LEAs, restando assim 11 artigos para inclusão na presente revisão sistemática (Chaudhary et al, 2018;Keratiotis et al, 2019;Khandewal et al, 2015;Khursheed et al, 2014;Mahmoud et al, 2021;Pishipati, 2013;Raghu et al, 2014;Rambabu et al, 2018;Ramezani et al, 2022;Shah et al, 2013;Tampelini et al, 2017).…”

“…• Of the studies evaluated, the aim of which was to compare the accuracy of the radiographic method and the electronic method in determining the TC, the majority showed no statistically significant difference in the results obtained between the two methods (Chaudhary et al, 2018;Keratiotis et al, 2019;Khandewal et al, 2015;Khursheed et al, 2014;Raghu et al, 2014;Rambabu et al, 2018). However, more studies show that the electronic method is more accurate than the radiographic method (Mahmoud et al, 2021;Pishipati, 2013;Ramezani et al, 2022;Shah et al, 2013;Tampelini et al, 2017) as shown in Table 2.…”

“…• Dos estudos avaliados cujo o objetivo era comparar a acurácia entre o método radiográfico e o método eletrónico na determinação do CT, a maioria não apresentou diferença estatisticamente significativa nos resultados obtidos entre os dois métodos (Chaudhary et al, 2018;Keratiotis et al, 2019;Khandewal et al, 2015;Khursheed et al, 2014;Raghu et al, 2014;Rambabu et al, 2018). No entanto, são mais os estudos que demontram maior acurácia por parte do método eletrónico relativamente ao método radiográfico (Mahmoud et al, 2021;Pishipati, 2013;Ramezani et al, 2022;Shah et al, 2013;Tampelini et al, 2017) como demonstrado na tabela 2.…”