J Korean Acad Oral Maxillofac Radiol.
1998 Aug;28(2):435-460.
The Accuracy of the Digital imaging system and the frequency dependent type apex locator in root canal length measurement
- Affiliations
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- 1Department of Dental Radiology, College of Dentistry, Yonsei University, Korea.
Abstract
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In order to achieve a successful endodontic treatment, root canals must be obturated three-dimensionally without causing any damage to apical tissues. Accurate length determination of the root canal is critical in this case. For this reason, I've used the conventional periapical radiography, Digora(R)(digital imaging system) and Root ZX(R) (the frequency dependent type apex locator) to measure the length of the canal and compare it with the true length obtained by cutting the tooth in half and measuring the length between the occlusal surface and the apical foramen. From the information obtained by these measurements, I was able to evaluate the accuracy and clinical usefulness of each systems, whether the thickness of files used in endodontic therapy has any effect on the measuring systems was also evaluated in an effort to simplify the treatment planning phase of endodontic treatment. 29 canals of 29 sound premolars were measured with #15, #20, #25 files by 3 different dentists each using the periapical radiography, Digora(R) and Root ZX. The measurements were then compared with the true length.
The results were as follows ;
1. In comparing mean discrepancies between measurements obtained by using periapical radiography(mean error : -0.449+/-0.444 mm), Digora(R)(mean error : -0.417+/-0.415 mm) and Root ZX(R) (mean error : 0.123+/-0.458 mm) with true length, periapical radiography and Digora(R) system had statistically significant differences(p<0.05) in most cases while root zx showed none>0.05).
2. By subtracting values obtained by using periapical radiography, Digora(R) and Root ZX(R) from the true length and making a distribution table of their absolute values, the following analysis was possible. In the case of periapical film, 140 out of 261(53.6%) were clinically acceptable satisfying the margin of error of less than 0.5 mm, 151 out of 261(53,6%) were acceptable in the Digora(R) system while Root ZX(R) had 197 out of 261(75.5%) within the limits of 0.5 mm margin of error.
3. In determining whether the thickness of files has any effect on measuring methods, no statistically significant differences were found(p>0.05).
4. In comparing data obtained from these methods in order to evaluate the difference among measuring methods, there was no statistically significant difference between periapical radiography and Digora(R) system(p>0.05), but there was statistically significant difference between Root ZX(R) and periapical radiography(p<0.05). also, there was statistically significant difference between Root ZX(R) and Digora(R) system(p<0.05).
In conclusion, Root ZX(R) was more accurate when compared with the Digora(R) system and periapical radiography and seems to be more effective clinically in determining root canal length. But Root ZX(R) has its limits in determining root morphology and nember of rootd and its accuracy becomes questionable when apical foramen is open due to unknown reasons. Therefore the combined use of Root ZX(R) and the periapical radiography are mandatory. Digora(R) system seems to be more effective when periapical radiographs are needed in a short period of time because of its short processing time and less exposure.