The accuracy of the radiographic method in root canal length measurement

For the successful endodontic treatment, root canal should be cleaned thoroughly by accurate mechanical and chemical canal preparation and sealed completely with canal filling material without damaging the periapical tissues. The accuracy of the root canal length measurement is a prerequisite for the success of the endodontic treatment, and the root canal length is often determined by the standard periapical radiographs and digital tactile sense. In this study, the accuracy and the clinical usefulness of Digora, an intraoral digital imaging processor and the conventional standard radiographs were compared by measuring the length from the top of the file to the root apex. 30 single rooted premolars were invested in a uniformly sized blocks and No.25 K-file was inserted into and fixed in each canal. Each block was placed in equal distance and position to satisfy the principle of the bisecting angle and paralleling techniques and Digora system's image and standard periapical radiographs were taken. Each radiograph was examined by 3 different observers by measuring the length from top of the file to the root apex and each data was compared and analyzed. The results were as follows; 1. In the bisecting angle technique, the average difference between the Digora system and standard periapical radiograph was 0.002 mm and the standard deviation was 0.341 mm which showed no statistically significant difference between the two systems (p>0.05). Also, in the paralleling technique, the average difference between these two system was 0.007 mm and the standard deviation was 0.323 mm which showed no statistically significant difference between the two systems (p>0.05). 2. In Digora system, the average difference between the bisecting angle and paralleling technique was -0.336 mm and the standard deviation was 0.472 mm which showed a statistically significant difference between the two techniques (p<0.05). Also, 3. In Digora system and the standard periapical radiographs, there was a statistically significant difference between the measurement using the bisecting angle technique and the actual length (p<0.05). But there was no statistically significant difference between the measurement using the paralleling technique and the actual length (p>0.05). In conclusion, the determination of the root canal length by using the Digora system can give us as good an image as the standard periapical radiograph and using the paralleling technique instead of the bisecting angle technique can give a measurement closer to the actual canal length, thereby contributing to a successful result. Also, considering the advantages of the digital imaging processor such as decreasing the amount of exposure to the patient, immediate use of the image, magnification of image size, control of the contrast and brightness and the ability of storing the image can give us good reason to replace the standard periapical radiographs.