Accuracy of endodontic working length determination using cone beam computed tomography

Connert, Thomas; Hülber-J, M.; Godt, Arnim; Löst, C; ElAyouti, Ashraf

doi:10.1111/iej.12206

Cited by 47 publications

(51 citation statements)

References 23 publications

(23 reference statements)

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“…The few studies that have measured the WL using CBCT have reported different results (Janner et al, 2011;Jeger et al, 2012;Liang et al, 2013;Connert et al, 2014;Lucena et al, 2014). A pilot study comparing CBCT with standard measurements techniques concluded that CBCT could be useful for determining the endodontic WL in combination with clinical measurements (Janner et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…A prospective controlled clinical study emphasized that CBCT can be used to measure endodontic WL, but that further studies are needed to evaluate whether CBCT can replace initial and WL periapical radiographs (Jeger et al, 2012). Authors showed that CBCT based-root canal length measurements are reliable and can be used to determine an accurate endodontic WL (Liang et al, 2013;Connert et al, 2014). Based on the literature, it can clearly be stated that different results on the WL measurements result from different voxel sizes of the CBCT scans.…”

Section: Discussionmentioning

confidence: 99%

“…An accurate determination of the working length (WL) is indispensable for successful endodontic treatment (Sjogren et al, 1990;Ng et al, 2008;Jeger et al, 2012;Connert et al, 2014). However, the location of the apical position constitutes a persistent challenge in clinical endodontics.…”

Section: Introductionmentioning

confidence: 99%

“…for the measurements of anatomic structure of craniofacial region due to its lower radiation doses and quicker image scanning times in comparison with computed tomography (Guijarro-Martinez and Swennen, 2011). While a few studies have evaluated the accuracy or validity of CBCT for measuring the endodontic, no consensus exists WL (Janner et al, 2011;Jeger et al, 2012;Liang et al, 2013;Connert et al, 2014;Lucena et al, 2014): some authors concluded that CBCT can be used to determine the endodontic WL in combination with EAL (Janner et al, 2011), while others stated that the limited CBCT scans can be used for WL measurements (Jeger et al, 2012;Liang et al, 2013). On the other hands, it revealed that electronic measurements were more reliable than CBCT scans for WL determination (Lucena et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Effects of voxel size and resolution on the accuracy of endodontic length measurement using cone beam computed tomography

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Karataşlıoğlu

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Annals of Anatomy - Anatomischer Anzeiger

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effects of voxel size and resolution on the accuracy of endodontic length measurement using cone beam computed tomography

Aktan

Yıldırım

Karataşlıoğlu

et al. 2016

Annals of Anatomy - Anatomischer Anzeiger

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“…It was useful in patients with cardiac pacemakers where the use of an apex locator is contraindicated and periapical radiography is unreliable. 50,51 Periapical radiography can't detect accurately if there is any existing periapical lesions post endodontic treatment. But, CBCT was useful in detecting the asymptomatic non-healed lesions during the posttreatment followup period to identify the cases requiring retreatment.…”

Section: Assessment Of the Quality Of Root Canal Treatment And Outcommentioning

confidence: 99%

Two Dimensional Versus Three Dimensional Imaging in Endodontics - An Updated Review

Sethi¹,

Tiwari²,

Das³

et al. 2016

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BACKGROUNDRadiographic imaging is a preliminary and essential step in the diagnosis, treatment planning and followup of all the cases in endodontics. The interpretation of an image can be influenced by several confounding factors including the regional anatomy a nd superimposition of both teeth and the surrounding dentoalveolar structures. Due to the complexity of the maxillofacial skeleton, conventional two dimensional (2-D) radiographic images fail to provide accurate information of the particular region of interest. Superimposition of the images, seen in planar periapical radiography, reveal only limited information about a three dimensional (3-D) object. The structures so visualised are also subject to geometric distortion. Hence, recent research has highlighted the need for 3-D imaging modality to overcome the potential drawbacks of conventional radiography. Medical Computed tomography (CT) was one of the earliest three dimensional imaging systems. It has been used in the field of endodontics over the past decade but with limited success. This can be ascribed to high radiation exposure, lengthy scan time and cost factor. The next new phase in imaging modalities came with the advent of cone beam computed tomography (CBCT). Contemporary endodontics emphasise on the significance of CBCT, since it limits the radiation exposure and rapidly provides 3D reconstructed images which have been proven to be accurate in all aspects. This paper reviews the importance of three dimensional CBCT technology over conventional two dimensional imaging system along with its potential drawbacks. BACKGROUND Diagnostic imaging is considered as an important adjunct in clinical assessment of the patient. Since time immemorial, radiology has played a critical role in dentistry and now with expanding array of different imaging modalities, it has become an indispensable tool in endodontic assessment as well. The first intraoral radiograph to be used in dentistry was reported by Sir C Edmond Kells. 1 Thereafter, field of radiology has seen several changes. With improvements in the film technology and reduced exposure times, gradually film based system gave way to advanced sensor based digital systems. Solid state sensors like charge coupled device (CCD), complementary metal oxide semiconductor (CMOS) and photostimulable phosphor plates (PSP) largely replaced the film based conventional imaging. 2, 3, 4 Digital systems also provided opportunities for image processing and modification (colour, brightness, contrast) which further assisted the diagnostic process. But the images were still a two dimensional representation of three dimensional anatomy and the need for cross sectional information was still unmet.

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Endodontic working length measurements of premolars and molars in high-resolution dental MRI: a clinical pilot study for assessment of reliability and accuracy

et al. 2022

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Objectives To prospectively assess the reliability and accuracy of high-resolution, dental MRI (dMRI) for endodontic working length (WL) measurements of premolars and molars under clinical conditions. Materials and methods Three-Tesla dMRI was performed in 9 subjects who also had undergone cone-beam computed tomography (CBCT) (mean age: 47 ± 13.5 years). A total of 34 root canals from 12 molars (4/8, upper/lower jaw; 22 root canals) and 11 premolars (2/9 upper/lower jaw; 12 root canals) were included. CBCT and dMRI datasets were reconstructed to visualize the root canal in one single slice. Subsequently, two radiologists measured the root canal lengths in both modalities twice in blinded fashion. Reliability and accuracy for both modalities were assessed using intraclass correlation coefficients (ICCs) and Bland–Altman analysis, respectively. Results Reliability (intra-rater I/II; inter-rater) of dental MRI measurements was excellent and comparable to CBCT for premolars (0.993/0.900; 0.958 vs. 0.993/0.956; 0.951) and for molars (0.978/0.995; 0.986 vs. 0.992/0.996; 0.989). Bland–Altman analysis revealed a mean underestimation/bias (95% confidence interval) of dMRI measurements of 0.8 (− 1.44/3.05) mm for premolars and 0.4 (− 1.55/2.39) mm for molars. In up to 59% of the cases, the accuracy of dMRI for WL measurements was within the underestimation margin of 0 to 2 mm short of the apical foramen AF. Conclusions In vivo demonstration and measurement of WL are feasible using dMRI. The reliability of measurements is high and equivalent to CBCT. Nonetheless, due to lower spatial resolution and longer acquisition time, the accuracy of dMRI is inferior to CBCT, impeding its current use for clinical treatment planning. Clinical relevance dMRI is a promising radiation-free imaging technique. Its reliability for endodontic working length measurements is high, but its accuracy is not satisfactory enough yet.

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Accuracy of endodontic working length determination using cone beam computed tomography

Abstract: Using a simplified method, CBCT images of 0.2 mm voxel size can be used to accurately determine endodontic WL.

Cited by 47 publications

References 23 publications

Effects of voxel size and resolution on the accuracy of endodontic length measurement using cone beam computed tomography

Effects of voxel size and resolution on the accuracy of endodontic length measurement using cone beam computed tomography

Two Dimensional Versus Three Dimensional Imaging in Endodontics - An Updated Review

Endodontic working length measurements of premolars and molars in high-resolution dental MRI: a clinical pilot study for assessment of reliability and accuracy

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