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Accuracy of Software-Based Three-Dimensional Root Canal Length Measurements Using Cone-Beam Computed Tomography
J P Tchorz1, K T Wrbas1, C Von See2
1Department of Operative Dentistry, Periodontology, and Endodontology, Center for Operative Dentistry, University of Dental Medicine and Oral Health, Danube Private University, Krems, Austria, Department of Operative Dentistry and Periodontology, Center for Dental Medicine, Medical Center, University of Freiburg, Freiburg, Germany.
Objective:
This study aims to evaluate the accuracy of three-dimensional root canal length measurements performed by dentists with different experience levels using a special software based on cone beam com-puted tomography (CBCT).
Methods:
A CBCT scan of an artificial resin maxillary molar was used to train dentists (n=65) in using the software (3D Endo, DentsplySirona, Ballaigues, Switzerland) as part of a continuing education course. At the beginning, each participant completed a questionnaire on endodontic and CBCT experiences. After com-prehensive instructions, each participant performed an entire three-dimensional treatment plan by tracing the root canal anatomy between the apical foramen and the center of the canal orifice and simulating a straight-line access. The final root canal length was indicated after the virtual rubber stop of a simulated instrument was adapted to the adjoining cusp. To evaluate the individual accuracy in terms of trueness and precision, differences between the three-dimensional planning and the actual root canal length (ARCL) were calculated, and statistically analyzed.
Results:
Mean absolute differences between the measurements with the 3D Endo™ software (n=260) and the ARCL were 0.30±0.22 mm. All measurements were within a limit of ±1 mm. The accuracy of root canal length measurements was significantly influenced by the type of root canal (p<0.0001). The smallest devia-tions were observed for the palatal root canal (0.18±0.13 mm), followed by the mesiobuccal (0.26±0.22 mm), the distobuccal (0.32±0.17 mm), and the second mesiobuccal root canal (0.46±0.24 mm).
Conclusion:
Within the limitations of this study, the 3D Endo software enables reproducible and accurate root canal length measurements as part of a three-dimensional endodontic treatment plan. However, mea-surements should always be clinically verified, as root canal morphology has a statistically significant influence.
