Measuring the Canal Length - A Review

Abstract

The objectives of root canal treatment are elimination of microorganisms, removal of pulpal remnants, removal of debris, and shaping of the root canal system so that it may be obturated. The most important step in endodontic therapy is canal preparation which can be achieved by accurate working length determination. Working length determines the extent of placing the instruments into the canal, it affects the degree of pain and discomfort which the patient will experience post treatment and it plays an important role in the success of the treatment if placed within correct limits. The cementodentinal junction, where the pulp tissue changes into the apical tissue, is the ideal physiologic apical limit of WL because at this point healing is supposed to be optimal, and the wound to the periapical tissues is minimal.The apical constriction is however, histological and is impossible to locate clinically or radiographically. There are several methods of determining working length which include radiographical methods, digital tactile sense, apical periodontal sensitivity, paper point method and electronic apex locators. The requirements of an ideal method for determining working length include rapid location of the apical constriction in all pulpal conditions, easy measurement, rapid periodic monitoring and confirmation, patient and clinician comfort, minimal radiation to the patient; ease of use in special patients; and cost effectiveness. To achieve the highest degree of accuracy in working length determination, a combination of several methods should be used. This article reviews the different methods to determine WL and their clinical implications. KEY WORDS Working Length, Apex Locator, Radiographic Method.