Comparison of root canal length measurement methods in primary teeth

Abstract

Objectives: The purpose of this study was to evaluate the accuracy of conventional radiography, intraoral digital radiovisiography and electronic apex locator in determining the working length of root canals in primary teeth (in-vivo) and to compare the results with scanning electron microscopy measurements (ex-vivo). Materials and Methods: This study was conducted on 50 primary molar teeth. Standard endodontic access cavity preparations were prepared and the actual length was calculated by calibrated investigators. Working lengths were determined by using conventional radiography, RVG and apex locator in a total of 116 root canals. After the extraction of the teeth, each canal length was determined by using SEM. Data were analysed statistically by using Oneway Anova, Tukey HDS, Student t test and Bonferroni tests. Results: The mean root length measurements with conventional radiography were significantly higher than apex locator, RVG and SEM. The accuracy of apex locator and RVG were higher than conventional radiography in determining the working length in primary teeth. Conclusions: The electronic apex locators provide an acceptable level of accuracy in determining root canal length in primary teeth. Clinical Relevance: The purpose of this study was to evaluate the accuracy of conventional radiography, intraoral digital radiovisiography and electronic apex locator in determining the working length of root canals in primary teeth and,to compare the results with scanning electron microscopy measurements.

Are electronic apex locators accurate in determining working length in primary teeth pulpectomies? A systematic review and meta‐analysis of clinical studies

“…In the sensitivity analysis, when considering only studies that were evaluated as 'low risk of bias' (Bhat et al, 2017;de Alencar et al, 2019;Oznurhan et al, 2015 difference between the electronic and radiographic measurements was −0.63 (95% CI [−1.15 to −0.10]; p = .02) (Figure S2). Nine studies were included for the radiovisiographic method (Abdullah et al, 2016;Awasthi et al, 2017;Balaji & Pravallika, 2019;Davalbhakta et al, 2021;Koruyucu et al, 2018;Kumar et al, 2016;Neena et al, 2011;Saritha et al, 2012;Wankhade et al, 2013), two for SEM (Koruyucu et al, 2018;Patino-Marin et al, 2011), and four for the visual direct method (Alafandy, 2018;Kumar et al, 2016;Senthil et al, 2016;Wankhade et al, 2013). The analysis showed that the electronic measurement did not differ statistically from the radiovisiographic method (−0.09; 95% CI [−0.22 to 0.04]; p = .20), SEM (−0.16; 95% CI [−0.83 to 0.50]; p = .63), and visual direct method (−0.05; 95% CI [−0.36 to 0.26]; p = .75).…”

“…Inter-and intra-examiner agreement was assessed only in 11 studies, in which values were considered excellent for all analyses used: Kappa (0.87 to 0.98) (Davalbhakta et al, 2021;Koruyucu et al, 2018;Kumar et al, 2016;Odabaş et al, 2011), ICC (0.80 to 0.99) (Alafandy, 2018;Hafiz, 2018a;Patino-Marin et al, 2011;Wankhade et al, 2013), Cronbach's alpha (0.95 to 0.99) (Alafandy, 2018;de Alencar et al, 2019), and Altmann & Bland (0.98) (Kielbassa et al, 2003).…”

“…A previous systematic review (Ahmad & Pani, 2015) was carried out; however, some limitations in this study need to be overcome to increase the certainty of the evidence, as most of the included studies were in vitro investigations. The most reliable evidence is obtained from well-conducted clinical studies and, since 2013 (the search date of the previous systematic review), several clinical studies have been performed to assess the accuracy of different EALs used for working length determination in primary teeth (Abdullah et al, 2016;Alafandy, 2018;Awasthi et al, 2017;Balaji & Pravallika, 2019;Bhat et al, 2017;Caliskan et al, 2021;Dandempally et al, 2013;Davalbhakta et al, 2021;de Alencar et al, 2019;Hafiz, 2018a;Koruyucu et al, 2018;Kumar et al, 2016;Nellamakkada et al, 2020;Nogorani et al, 2014;Oznurhan et al, 2015;Rathore et al, 2020;Sankar & Jeevanandan, 2021;Senthil et al, 2016;Sivadas et al, 2013;Soruri et al, 2013;Wankhade et al, 2013). However, the results of these studies have not been are based on clinical studies with low methodological quality and high heterogeneity, which require careful interpretation for clinical practice.…”

“…T A B L E 1Considering the number of examiners who performed the measurements, one study used four examiners(Patino-Marin et al, 2011), five studies used three examiners(Alafandy, 2018;Chougule et al, 2012;de Alencar et al, 2019;Kumar et al, 2016;Sivadas et al, 2013), six studies used two examiners (Caliskan Abbreviations: ICC, interclass correlation coefficient; N/I, not informed; non-RCT, non-randomized clinical trial; RCT, randomized clinical trial; RVG, radiovisiography; SD, standard deviation; SEM, scanning electron microscopy; y, years old.T A B L E 1 ContinudeDavalbhakta et al, 2021;Ghaemmaghami et al, 2008;Kielbassa et al, 2003;Koruyucu et al, 2018;Odabaş et al, 2011), and 17 studies used a single examiner(Abdullah et al, 2016;Awasthi et al, 2017;Balaji & Pravallika, 2019;Beltrame et al, 2011;Bhat et al, 2017;Dandempally et al, 2013;Hafiz, 2018a;Neena et al, 2011;Nellamakkada et al, 2020;Nogorani et al, 2014;Oznurhan et al, 2015;Rathore et al, 2020; …”

Assessment of Working Length of Root Canal in Mandibular First Primary Molar in Children Aged between 2 to 6 Years

“…Electronic apex locator methods give accurate root canal length when compared to other methods (24). Working length determination is an important factor for the success of root canal treatment, the canal should be prepared till the apical constriction or apical foramen 25 . The use of arbitrary Working length in anxious children is to reduce the duration of treatment for better cooperation from the child and to improve the quality of the treatment.…”