Comparison of Accuracy and Reliability of Working Length Determination Using Cone Beam Computed Tomography and...

To compare the accuracy and reliability of cone beam computed tomography (CBCT) and electronic apex locator (EAL) in determining the working length (WL).

A comprehensive literature search was conducted across several databases and gray literature. A total of 1,358 potentially relevant journal articles were identified with publication dates ranging from 1996 to 2017. After screening and applying the inclusion and exclusion criteria, five studies were identified as eligible for review. Data extraction was completed in two blinded pairs, cross-referenced and subsequently merged. Discrepancies were resolved through collaborator mediation. Meta-analysis was not undertaken due to heterogeneity between included studies.

In all five studies, no statistically significant difference was found between CBCT and EAL measurements of WL. The reliability of CBCT compared with EAL was not determined.

Due to significant heterogeneity between the included studies, the accuracy of CBCT compared to EAL couldn't be determined. Based on limited evidence, CBCT appeared to be as accurate as EAL. There was weak evidence suggesting that CBCT was reliable. Also the superiority of one method over the other could not be determined. These results should be interpreted judiciously. Further research is required to conclusively evaluate the accuracy and reliability of CBCT compared with EAL.

Preexisting CBCT scans may be appropriate for WL determination but acquiring a new CBCT for endodontic treatment is inadvisable due to cost and the as low as reasonably achievable (ALARA) principle.