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Radiographic "working length" revisited.

T J Stein1, J F Corcoran

  • 1Veterans Administration Medical Center, Ann Arbor, Mich.

Oral Surgery, Oral Medicine, and Oral Pathology
|December 1, 1992
PubMed
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Radiographs often inaccurately determine root canal working length, appearing shorter than the actual file position. This study suggests adjusting the accepted distance from the apex to prevent overfilling during endodontic procedures.

Area of Science:

  • Endodontics
  • Dental Radiology
  • Root Canal Anatomy

Background:

  • Accurate determination of root canal "working length" is critical for successful endodontic treatment.
  • Traditionally, radiographs are used for working length assessment and obturation evaluation.
  • Electronic apex locators are emerging as potential replacements for radiographic methods.

Purpose of the Study:

  • To evaluate the accuracy of radiographic methods in determining root canal working length.
  • To compare radiographic working length with actual file position.
  • To assess the implications of radiographic inaccuracies in endodontic procedures.

Main Methods:

  • Eighty-seven vital and 24 nonvital teeth were accessed for biomechanical preparation.
  • Files were placed to the radiographic working length.

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  • Teeth and files were extracted and sectioned for precise measurement.

    • Main Results:

    • Radiographic measurements consistently underestimated the actual file position by an average of 0.7 mm.
    • This discrepancy can lead clinicians to inadvertently place files closer to the apical vertex than suspected.
    • The study highlights potential for overfilling due to radiographic inaccuracies.

    Conclusions:

    • Radiographs are not consistently accurate for determining root canal working length.
    • A revised distance of 1.5–2.0 mm from the apical vertex is recommended to prevent overfilling.
    • Clinicians should be aware of radiographic limitations and consider alternative methods for precise working length determination.