Comparison of Working Length Determination in Teeth with Vital Pulps with Digital Radiographs and Four Electronic Apex Locators. An In Vivo Study

Abstract

Introduction: The aim of this study was to evaluate in vivo the accuracy and predictability of four EALs for determining working length as compared to radiographs: RootZX, Apex ID, Joypex 5 and Propex Pixi. Methods: One hundred and twenty patients (247 canals) contributed in the study. The measurements obtained by the four EALs and radiographs relative to the actual location of the AC were compared using a paired samples t test, X2 test. Results: For anterior teeth, EALs and radiographs located the minor foramen 87%, 75%, 75%, 87% and 62% of the time, respectively. For premolar teeth, EALs and radiographs located the minor foramen 92.85%, 85.71%, 78.57%, 85.71% and 57.14% of the time, respectively. For molar teeth, the Root ZX, EALs and radiographs located the minor foramen 90%, 85%, 80%, 85% and 70% of the time, respectively. There was no statistically significant difference between the four EALs but there was a difference bet the EALs and radiographs. p= 0.05. Conclusion: Under clinical conditions the EALs identified the apical constriction (minor foramen) with high degree of accuracy. EAL were more accurate, compared to radiographs with the potential to greatly reduce the risk of instrumenting and filling beyond the apical foramen.