Accuracy of the electronic method versus the radiographic method in determining working length: integrative systematic review

Introduction: The radiographic method is widely used to calculate the working length (CT). However, it presents limitations that, to overcome them, apical electronic locators (LEAs) were developed to allow greater accuracy and reliability in determining the CT. Objective: The present study aims to perform an integrative systematic review and gather the available scientific evidence on the method that allows greater accuracy in determining the CT between the radiographic method and the electronic localisation method (LEA). Materials and Methods: The literature search was performed on the PubMed platform using keywords combined through the Boolean operator AND as follows: ("endodontics" AND "electronic apex locator" AND "radiographic measurement") and ("endodontics" AND "electronic apex locator" AND "radiographic measurement" AND "odontometry"). Results: 68 articles reporting comparative studies performed between the methods, radiographic and LEA, were identified. Eleven studies were included, of which, in some cases, LEAs showed better results than non-digital periapical radiographs. The studies indicate that although there are differences between the two methods, with greater accuracy in determining LEA, the differences did not prove to be statistically significant. In the presence of irrigating solutions, sodium hypochlorite revealed more significant discrepancies in CT determination with the LEA method. Conclusion: The two methods, radiographic and LEA, should be used in association since each has particularities that present more significant benefits enhancing the success of endodontic treatment and a better and more complete treatment for patients.