NDLI: Efficacy of electronic apex locators in comparison with intraoral radiographs in working length determination- a systematic review and meta-analysis

Content Provider	Springer Nature : BioMed Central
Author	Kaur, Gurveen Thomas, Anchu Rachel Samson, Renu Sarah Varghese, Eby Ponraj, Ratna Rachel Nagraj, Sumanth Kumbargere Shrivastava, Deepti Algarni, Hmoud Ali Siddiqui, Amna Yusuf Alothmani, Osama S. Srivastava, Kumar Chandan
Abstract	Background Successful endodontic treatment needs accurate determination of working length (WL). Electronic apex locators (EALs) were presented as an alternative to radiographic methods; and since then, they have evolved and gained popularity in the determination of WL. However, there is insufficient evidence on the post-operative pain, adequacy, and accuracy of EALs in determining WL. Objective The systematic review and meta-analysis aims to gather evidence regarding the effectiveness of EALs for WL determination when compared to different imaging techniques along with postoperative pain associated with WL determination, the number of radiographs taken during the procedure, the time taken, and the adverse effects. Methods For the review, clinical studies with cross-over and parallel-arm randomized controlled trials (RCTs) were searched in seven electronic databases, followed by cross-referencing of the selected studies and related research synthesis. Risk of bias (RoB) assessment was carried out with Cochrane's RoB tool and a random-effects model was used. The meta-analysis was performed with the RevMan software 5.4.1. Results Eleven eligible RCTs were incorporated into the review and eight RCTs into the meta-analysis, of which five had high RoB and the remaining six had unclear RoB. Following meta-analysis, no significant difference in postoperative pain was found among the EAL and radiograph groups (SMD 0.00, CI .29 to .28, 354 participants; P value = 0.98). Radiograph group showed better WL accuracy (SMD 0.55, CI .11 to .99, 254 participants; P value = 0.02), while the EAL group had 10% better WL adequacy (RR 1.10, CI 1.03–1.18, 573 participants; P value = 0.006). Conclusion We found very low-certainty evidence to support the efficacy of different types of EAL compared to radiography for the outcomes tested. We were unable to reach any conclusions about the superiority of any type of EAL. Well-planned RCTs need to be conducted by standardizing the outcomes and outcome measurement methods.
Related Links	https://bmcoralhealth.biomedcentral.com/counter/pdf/10.1186/s12903-024-04259-w.pdf
Ending Page	17
Page Count	17
Starting Page	1
File Format	HTM / HTML
ISSN	14726831
DOI	10.1186/s12903-024-04259-w
Journal	BMC Oral Health
Issue Number	1
Volume Number	24
Language	English
Publisher	BioMed Central
Publisher Date	2024-05-04
Access Restriction	Open
Subject Keyword	Dentistry Oral and Maxillofacial Surgery Endodontic Root canal treatment Working lengt Radiographs Apex locator
Content Type	Text
Resource Type	Article
Subject	Dentistry
Journal Impact Factor	2.6/2023
5-Year Journal Impact Factor	3.2/2023

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