Citation: Anindita Talukdar et al (2021). Working Length Determination Using Apex Locator and Cone Beam Computed
Tomography in Presence of Three Irrigating Solutions in Primary Teeth: An In Vitro Comparative Study. Saudi J Oral Dent Res,
6(2): 92-96.
92
Saudi Journal of Oral and Dental Research
Abbreviated Key Title: Saudi J Oral Dent Res
ISSN 2518-1300 (Print) |ISSN 2518-1297 (Online)
Scholars Middle East Publishers, Dubai, United Arab Emirates
Journal homepage: https://saudijournals.com
Original Research Article
Working Length Determination Using Apex Locator and Cone Beam
Computed Tomography in Presence of Three Irrigating Solutions in
Primary Teeth: An in Vitro Comparative Study
Anindita Talukdar
1*
, Prakash Chandra
2
, Latha Anandakrishna
3
1
Private consultant, Pedodontist Guwahati, India
2,3
Professor, Department of Paediatric Dentistry, Faculty of Dental Sciences, M S Ramaiah University of Applied Sciences, Bengaluru, India
DOI: 10.36348/sjodr.2021.v06i02.002 | Received: 02.02.2021 | Accepted: 12.02.2021 | Published: 16.02.2021
*Corresponding author: Dr. Anindita Talukdar
Abstract
The purpose of the present study was to determine the working length using electronic apex locator in various intracanal
mediums and cone beam computed tomography scan and to compare the lengths with the actual length of the tooth.
Methods: In an in vitro setting, a total of 45 primary molar roots were decoronated till the cemento enamel junction for
standardization, working length was measured with the Apex DSP (Septodont, France) at the ‘apex’ in presence of three
different irrigating solutions namely 0.9 % saline, 0.2 % chlorhexidine and 2.5 % sodium hypochlorite. The radiological
working length was then calculated with cone beam computed tomography scans. The collected data was analyzed using
descriptive statistics. Independent‘t’ test was done to compar e the working length between the groups. Results: Findings
showed there was significant difference in working length determination using apex locator in presence of saline and
chlorhexidine when compared to sodium hypochlorite. Also working length determination with cone beam computed
tomography compared to actual length did not show any significant difference. Conclusion: Apex DSP can be
considered to be accurate across a variety of irrigants commonly used in the pediatric endodontic practice. A CBCT scan
can be used as a diagnostic tool for pulpal treatment when treating multiple carious lesions.
Keywords: Working length, apex locator, chlorhexidine, sodium hypochlorite, Cone beam computed tomography.
Copyright © 2021 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International
License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original
author and source are credited.
INTRODUCTION
Endodontic treatment in pedodontics requires
treatment of pulpally involved primary and young
permanent teeth in children to maintain the integrity and
health of the oral tissues and also it is desirable to
maintain pulp vitality wherever possible[1]. In
permanent teeth, definitive rules for successful
endodontic therapy have been established such as dense
obturation and apical/coronal seal. In contrast, in
pediatric endodontics, because of open apices, there are
technical hitches in estimating the exact root canal
length [2]. Working length determination is an
important step in successful root canal therapy [3]. The
accurate determination of working length has a major
impact on the outcome of successful endodontic
treatment in primary dentition. Frequently used method
for determining working length are periapical
radiographs. However there are various shortcomings in
using conventional radiographs which includes the
sensitivity of the technique, subjectivity and errors due
to image magnification, distortions or the
superimposition of anatomical structures [4].
Moreover, while performing endodontic
procedure in children various factors should be taken
into consideration like the time taken for the procedure,
feasibility of taking multiple radiographs for working
length determination. In such cases apex locator might
be of importance as this device can be used with ease
and also reduces the number of radiographs. Again with
the advent of newer technologies like Cone-beam
computed tomography (CBCT) which is a
contemporary radiological imaging system, undistorted
images can be obtained with a significantly lower-
effective radiation dose than conventional computed
tomography[5]. Hence the null hypothesis is that there
is no significant difference in the diagnostic ability of
CBCT scan and apex locator in different solutions when