A comparative study of three periapical radiographic techniques for endodontic working length estimation

Area of Science:

• Dentistry
• Radiology
• Endodontics

Background:

• Accurate working length determination is crucial for successful endodontic treatment.
• Traditional bisecting angle technique can lead to diagnostic errors in working length radiographs.
• Film holders offer a standardized approach to radiographic positioning.

Purpose of the Study:

• To compare the diagnostic quality of endodontic working length estimation films.
• To evaluate films produced using film holders versus the bisecting angle technique.
• To assess operator and patient acceptance of film holders.

Main Methods:

• Dental students used paralleling technique with film holders (Endoray II, XCP) or bisecting angle technique.
• Radiographs were assessed for diagnostic acceptability and film faults.
• Operator ease of use and patient comfort were recorded.

Main Results:

• Paralleling technique with film holders yielded significantly fewer unacceptable radiographs (16.7%) than the bisecting angle technique (48.6%).
• Significant reductions in vertical angulation errors, cone cutting, and film placement errors were observed with film holders.
• Operators rated film holders excellent/good in 90% of cases; 47.5% of patients reported no discomfort.

Conclusions:

• Film holders enhance the diagnostic quality of endodontic working length estimation radiographs.
• The paralleling technique, facilitated by film holders, is superior to the bisecting angle technique for this purpose.
• Film holders are a valuable tool for improving accuracy in endodontic radiography.