Comparison of Accuracy and Reliability of Working Length Determination Using Cone Beam Computed Tomography and Electronic Apex Locator: A Systematic Review

This study evaluated the accuracy of the Wirele‐X (Forum Tec, Ashkelon, Israel), a novel Bluetooth‐enabled wireless electronic apex locator. Thirty‐one extracted teeth with mature apices were used. Under 10X magnification, the actual canal lengths were determined. The teeth were embedded in alginate and electronic canal lengths were obtained using the Root ZX II and Wirele‐X electronic apex locators. The actual canal lengths and electronic canal lengths were compared with Student's t‐test. The average distance from the file tip to the actual canal length was −0.11 mm (±0.16) for the Root ZX II, and − 0.07 mm (±0.21) for the Wirele‐X. There were no statistically significant differences between the two electronic apex locators in their ability to determine the actual canal length (p > 0.05). The wireless apex locator (Wirele‐X) and the wired apex locator (Root ZX II) were found to be equally accurate.

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Efficacy of electronic apex locators in comparison with intraoral radiographs in working length determination- a systematic review and meta-analysis

Kaur,

Thomas,

Samson

et al. 2024

BMC Oral Health

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Background Successful endodontic treatment needs accurate determination of working length (WL). Electronic apex locators (EALs) were presented as an alternative to radiographic methods; and since then, they have evolved and gained popularity in the determination of WL. However, there is insufficient evidence on the post-operative pain, adequacy, and accuracy of EALs in determining WL. Objective The systematic review and meta-analysis aims to gather evidence regarding the effectiveness of EALs for WL determination when compared to different imaging techniques along with postoperative pain associated with WL determination, the number of radiographs taken during the procedure, the time taken, and the adverse effects. Methods For the review, clinical studies with cross-over and parallel-arm randomized controlled trials (RCTs) were searched in seven electronic databases, followed by cross-referencing of the selected studies and related research synthesis. Risk of bias (RoB) assessment was carried out with Cochrane's RoB tool and a random-effects model was used. The meta-analysis was performed with the RevMan software 5.4.1. Results Eleven eligible RCTs were incorporated into the review and eight RCTs into the meta-analysis, of which five had high RoB and the remaining six had unclear RoB. Following meta-analysis, no significant difference in postoperative pain was found among the EAL and radiograph groups (SMD 0.00, CI .29 to .28, 354 participants; P value = 0.98). Radiograph group showed better WL accuracy (SMD 0.55, CI .11 to .99, 254 participants; P value = 0.02), while the EAL group had 10% better WL adequacy (RR 1.10, CI 1.03–1.18, 573 participants; P value = 0.006). Conclusion We found very low-certainty evidence to support the efficacy of different types of EAL compared to radiography for the outcomes tested. We were unable to reach any conclusions about the superiority of any type of EAL. Well-planned RCTs need to be conducted by standardizing the outcomes and outcome measurement methods.

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Comparison of Accuracy and Reliability of Working Length Determination Using Cone Beam Computed Tomography and Electronic Apex Locator: A Systematic Review

Cited by 8 publications

References 20 publications

Optimizing radiation safety in dentistry

Optimizing radiation safety in dentistry

An in vitro evaluation of the WIRELE‐x electronic apex locator

Efficacy of electronic apex locators in comparison with intraoral radiographs in working length determination- a systematic review and meta-analysis

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