The fundamental operating principles of electronic root canal length measurement devices

It is generally accepted that root canal treatment procedures should be confined within the root canal system. To achieve this objective the canal terminus must be detected accurately during canal preparation and precise control of working length during the process must be maintained. Several techniques have been used for determining the apical canal terminus including electronic methods. However, the fundamental electronic operating principles and classification of the electronic devices used in this method are often unknown and a matter of controversy. The basic assumption with all electronic length measuring devices is that human tissues have certain characteristics that can be modelled by a combination of electrical components. Therefore, by measuring the electrical properties of the model, such as resistance and impedance, it should be possible to detect the canal terminus. The root canal system is surrounded by dentine and cementum that are insulators to electrical current. At the minor apical foramen, however, there is a small hole in which conductive materials within the canal space (tissue, fluid) are electrically connected to the periodontal ligament that is itself a conductor of electric current. Thus, dentine, along with tissue and fluid inside the canal, forms a resistor, the value of which depends on their dimensions, and their inherent resistivity. When an endodontic file penetrates inside the canal and approaches the minor apical foramen, the resistance between the endodontic file and the foramen decreases, because the effective length of the resistive material (dentine, tissue, fluid) decreases. As well as resistive properties, the structure of the tooth root has capacitive characteristics. Therefore, various electronic methods have been developed that use a variety of other principles to detect the canal terminus. Whilst the simplest devices measure resistance, other devices measure impedance using either high frequency, two frequencies, or multiple frequencies. In addition, some systems use low frequency oscillation and/or a voltage gradient method to detect the canal terminus. The aim of this review was to clarify the fundamental operating principles of the different types of electronic systems that claim to measure canal length.