The effect of an apex locator on exposure to radiation during endodontic therapy

The objective of this study was to investigate whether the use of an electronic apex locator results in a reduction in X-ray exposure during endodontic therapy. Fifty, sound, extracted, single-rooted canine and incisor teeth were selected and randomly divided into two groups (A and B) of 25 teeth. The working length was determined radiographically with (group B) and without (group A) adjunctive use of an apex locator by one operator. After working length determination, the teeth were sectioned and the actual working length measured for comparison. For group A, 14 retake radiographs were required to determine the working length, whereas group B required no retake radiographs; this difference was highly significant (p < 0.001). The electronic apex locator was extremely accurate in locating the apical foramen with all teeth tested within 0.5 mm of the anatomical apex and 11 (44%) teeth at the apical foramen. In contrast, 15 (60%) teeth tested using radiographs alone were within 0.5 mm of the anatomical apex and only 4 (16%) teeth were actually at the anatomical apex. It was concluded that using an electronic apex locator as an aid to endodontic therapy could potentially reduce the number of diagnostic radiographs required for working length determination. Location of the apical foramen using a combination of an electronic apex locator and radiographs to determine working length is more accurate than using radiographs alone.