Determination of an accurate working length(WL)is one of the most critical steps of endodontic therapy.the cleaning, shaping and obturation of root canal system cannot be acomplished accurately unless WL is determined precisely.

According to endodontic glossary : W.L is defined asµ the distance from a coronal reference point to a point at which canal preparation obturation should terminate.µ

€ .€ Reference point : is that site on occlusal or the incisal surface from which measurements are made . € Radiographic apex: is tip or end of root determined radiographically. A reference point is chosen which is stable and easily visualized during preparation. Anatomic apex: is tip or end of root determined morphologically .

€ Apical constriction: is apical portion of root canal having narrowest diameter .Apical foramen: is main apical opening of root canal which may be located away from anatomic or radiographic apex. € It is usually 0.5-1mm short of apical foramen. € The Cementdentinal junction:is the region where cementum and dentine are united . € .the point at which cemental surface terminate at or near the apex.

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Average root length from anatomic studies € Radiographic € Mathematics method € Tactile sensation € Bleeding on paper point € Apical periodontal sensitivity € Electronic apex locator € .

correct WL is finally calculated by subtracting 1 mm from this new length . . 5.1. 4. Measure the estimated WL from preoperative periapical radiograph Adjust stopper of instrument to this estimated WL and place it in the canal up to the adjusted stopper Take the radiograph On the radiograph measure the difference between the tip of the instrument and the root apex add or subtract this length to the estimated WL to get the new WL. 2. 3.

5 mm 3. Periapical bone lesion . .No resorption -subtract 1mm 2.subtract 1. Periapical bone +root apex resorption -subtract 2 mm 1.

€ In this an instrument is inserted into the canal . € .it is based on simple mathematical formulation to calculate the WL.stopper is fixed to the reference point and radiograph is taken.

€ The formula to calculate actual length of the tooth ia as follow: Actual length of tooth apperent length of tooth in x-ray -------------------------------.= -----------------------------------------------Actual length of instrument apperent length of instrument in radiograph So. actual length of instrument X apperent length of tooth in radiograph Actual length of tooth= -----------------------------------------------------------apperent length of instrument in radiograph .--.

. Variation in angles of radiograph B.Wrong readings can occur because of : A.double curvature roots. Curved root C. S-shaped .

€ .Other methods of WL determination including:  tactile sensation  Apical periodontal sensitivity  Paper point measurement These methods don·t always provide the accurate readings for example : In case of narrow canals instrument may feel increased resistance as file approaches apical 2-3mm and in case tooth with immature apex instrument can go beyond apex. So these methods should not used alone should be used as supplement to radiographs apex locators.

as these signify essentially how the device interprets the data. € Suzuki conducted research in 1942 and this was used by Sunanda € .The electronic method calculates the working length by comparing the electrical resistance of the periodontal membrane with that of the gingival surrounding the tooth. both of which should be similar. The processors of these both of these machines basically work on four mechanisms. The apex locators are also classified based on the principle they work on. All apex locators function by using human body to complete a circuit. § Log readings § Subtract method § Taking averages § Taking ratios € These mechanisms are more important as compared to the number of frequencies used to collect data.

The apex principles: € § § locators are base on three Resistance method Impedance method § Frequency ratio method .

The file is then advanced into the canal until it touches the periodontal tissue at the apex which then completes the circuit.Resistance Method (First Generation Apex Locators) € The apex locator has a built in resistant value of 6. The apex locator is attached to the patients lip on one side and the other side is attached to the file.5 kilo Ohms. .

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€ Operates on the principle that there is electrical impedance across the walls of the root canal due to the presence of the transparent dentin. At the DCJ. . the level of impedance drops dramatically. which is greater apically than coronally. The unit detects the sudden change and indicates it on the analogue meter. The tooth exhibits an increasing electrical impedance across the walls of the root canal. To overcome the problem of a wet environment. insulated are utilized.

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€ Operates very similarly to the Impedance-type because it measures the impedance of the tooth at two different frequencies. In the coronal portion of the canal. As the file is advanced apically. the difference in the impedance value begins to differ greatly with maximum difference at the apical area. . the impedance difference between the frequencies is constant.

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.´fourth-generationµ apex locators are marketed by Sybron Endo and included the AFA Apex Finder and the Elements Diagnostic Unit. Both are ratio type apex locators that determine the impedance at 5 frequencies and both have built-in electronic pulp testers.

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Fifth generation of apex locater : this type of apex locater contain rotary endo system (built in) .

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€ EAP are used for determining WL as an adjunct to radiography. . They are basically used to locate the apical constrictions or cementodentinal junction or apical foramen and not the radiographic apex.

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Useful in patient with gag reflex Pregnant patient Root perforation . . 6. 2. Provide high degree of accuracy Useful in conditions where apical portion is obstructed. 5.1.resorption . 3.root fracture . Pulp vitality RCT of teeth with incomplete root formation. 7. 4.

Accurate € Objective measurement € Easy and fast € Reduction of exposure to radiation € Perforation can be detected € Can measure pulp space exactly to constriction € Can detect resorption and root fracture € .

Canal should be free from debris € Canal should be relatively dry € No cervical leakage € Proper contact of file with canal walls and periapex € No blockages or calcification in canal € .

electrical stimulation to such patient can interfere with pace maker function € In teeth with periapical radiolucency and necrotic pulp associated with root resorption the use of apex locator is not much beneficial. € .In patient who have cardiac pace maker.

€ The consideration should given to adopt the parameter 0. € We should use many of these techniques as possible during the course of treatment.The most important to understand when determining WL is morphology of apical one third of the canal.5-0. € .0mm(from apical constriction)as most ideal terminating point in canal.

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