Accuracy of working length determination using 3 electronic apex locators and direct digital radiography

Objectives: The objectives of this study were to assess the accuracy of working length determination using 3 electronic apex locators and direct digital radiography and to compare the results with those obtained using the visual method (control measurement).

Study design: Twenty extracted human maxillary premolars were selected: 17 two-rooted and 3 single-rooted (total of 37 canals). Working length was measured using electronic apex locators Elements Diagnostic, Root ZX, and Just II. Subsequently, teeth were positioned in the alveolar bone of a dry skull and submitted to direct digital radiography. A variation of ±1 mm was considered as acceptable. Results were analyzed using the Wilcoxon and the χ(2) tests.

Results: Results presented an accuracy of 94.6% for Elements Diagnostic, 91.9% for Root ZX, 73.0% for Just II, and 64.9% for direct digital radiography when considering the margin of ±1 mm in relation to the control measurement. Comparisons with the actual control measurements resulted in accuracy results of 13.51%, 13.51%, 10.10%, and 2.70%, respectively.

Conclusions: Root ZX and Elements Diagnostic are more accurate in determining working length when compared with Just II and Schick direct digital radiography.