Accuracy of Working Length Determination - Electronic Apex Locator Versus Cone Beam Computed Tomography

ABSTRACT Objective: To compare the accuracy of working length determination between cone beam computed tomography (CBCT) and electronic apex locator by measuring the actual working length of teeth. Material and Methods: A total of 150 single-rooted tooth assessed by radiograph undergoing root canal therapy were selected. The process was repeated to obtain a buccolingual and mesiodistal section of all teeth. The measurement line was considered from the reference occlusal plane following the center of the canal to the terminus. All information regarding the accuracy of cone-beam computed tomography and apex locator was noted in a pre-designed proforma. Results: CBCT consistently demonstrated high accuracy across all tooth types in both jaws. The electronic apex locator exhibited varying precision, with greater accuracy observed in the mandible. Statistical analyses revealed significant differences in electronic apex locator accuracy among tooth types in the maxilla (p=0.042), emphasizing the importance of specific clinical considerations. Conclusion: Cone beam computed tomography emerges as a reliable diagnostic tool for accurate working length determination, especially in complex cases, while the electronic apex locator remains valuable with careful consideration of potential variations in accuracy. An individualized approach, considering tooth type, jaw location, and clinical context, is crucial for precise working length determination in endodontic practice.

Caries affected disinfection using Phycocyanin activated by PDT, Holy Basil, and Ti-sapphire laser on adhesive bond strength, microleakage, and bond failure.

AIM: To investigate the effect of different cavity disinfectants, Phycocyanin (PC), Ocimum Sanctum (OS), and Ti Sapphire Laser, on the bond integrity and microleakage of resin restorations. MATERIAL AND METHOD: 60 human mandibular molars were extracted and prepared based on ICDAS scores of 4 and 5. To obtain the CAD surface, a visual examination was supported by tactile sensation and a dye for caries detection. Samples were randomly allocated into 4 groups based on cavity disinfectants applied (n = 15). Group 1: Specimens disinfected with CHX, Group 2: Specimens disinfected with Ti sapphire laser, Group 3: Specimens disinfected with Phycocyanin activated by Photodynamic therapy, and Group 4: Specimens disinfected with OS. Following the disinfection of the CAD surfaces, composite bulk-fill restorative material was bonded to each specimen and all samples were subjected to thermocycling. Ten samples from each group underwent SBS testing performed on a universal testing machine. Five samples were subjected to a microleakage analysis. RESULT: The maximum microleakage scores were displayed by Group 3: PC (0.521 nm) treated specimens. Whereas, and minimum microleakage was exhibited by Group 4: OS (0.471 nm). Group 4: OS (23.06±0.21 MPa) treated group displayed the maximum bond scores of resin adhesive to the CAD surface. However, Group 3: PC (21.67±0.24 MPa) treated specimens exhibited the lowest bond scores. Failure mode analysis revealed that among all the investigated groups the predominant type of failure was cohesive failure i.e., Group 1 (80%), Group 2 (80%), Group 3 (70%), and Group 4 (90%). CONCLUSION: Ocimum Sanctum, Phycocyanin activated by Photodynamic therapy, and Ti-sapphire laser for disinfection of caries-affected dentin have shown promise in terms of improved bond strength and reduced microleakage.