In Vitro Comparison of the Accuracy of Cone-Beam Computed Tomography Scanning and Electronic Apex Locators in Detection of Simulated Root Perforations in Different Localizations.

AIM: This study aimed to compare the accuracy of cone-beam computed tomography (CBCT) scanning and two different electronic apex locators (EALs) in the detection of simulated root canal perforations in different localizations.

MATERIALS AND METHOD: Eighty human mandibular premolars were prepared and divided into two groups according to the localization of the perforation area, having a 1 mm diameter. The distance between the occlusal edge and the beginning of the perforation was measured under a stereomicroscope (actual working length=AWL), by using two electronic apex locators (Propex II and Dentaport ZX) (electronic working length=EWL) and CBCT images (CWL). The calculations were made by subtracting AWL from EWL and CWL to determine the differences.

RESULTS: In the apical third perforation group, there was a significant difference between the Dentaport ZX and CBCT. There was no significant difference between Dentaport ZX and Propex II, and Propex II and CBCT measurements. In the middle third perforation group, Propex II was significantly more successful than CBCT. In addition, there was no significance between the accuracy of Propex II in detecting the perforation area between the apical third perforation group and the middle third perforation group. CBCT was more accurate in detecting the perforation area in the apical third perforation group than in the middle third perforation group.

CONCLUSION: In cases where the root canal perforation was in the apical third of the root, both EAL and CBCT were successful in determining the perforation area, while the success rate of all devices used in this study decreased when the perforation area was in the middle third of the root.