ACCURACY AND CLINICAL APPLICATIONS OF ELECTRONIC APEX LOCATORS IN PRIMARY TEETH: A SCOPING REVIEW

Dr. Srishti K. M.*, Dr. Deepak B. M., Dr. Basappa N., Dr. Chandrashekhar Yavagal

ABSTRACT

Background: Accurate working length determination is critical in pediatric endodontics due to anatomical variability and physiological root resorption in primary teeth. Electronic apex locators (EALs) offer a radiation-free and efficient alternative to conventional radiography; however, their accuracy remains under scrutiny. Objective: To map and evaluate the diagnostic accuracy, clinical applications, and advancements of various generations of electronic apex locators in primary teeth. Methods: A scoping review was conducted according to the Joanna Briggs Institute framework and reported following PRISMA-ScR guidelines. Studies published between January 2014 and May 2025 were identified through electronic searches of PubMed, EBSCO and Google Scholar using keywords such as “electronic apex locator”, “working length”, “tooth apex”, and “primary teeth”. In vitro and in vivo studies in English assessing EAL use in primary teeth were included. Results: A total of[14] studies were included (9 in vitro, 5 clinical). Third-generation apex locators, especially the Root ZX series, showed high accuracy. Fifth and sixth-generation devices demonstrated potential advantages in fluid-filled canals and in cases of apical root resorption. Results varied across devices and canal conditions. Few studies evaluated newer EALs or the effect of irrigants on accuracy. Conclusions: EALs are reliable tools for working length determination in primary teeth. Third-generation devices dominate the literature, though newer generations show promise. Further high-quality clinical studies are needed to assess their performance under varied canal conditions.

Keywords: Clinical accuracy; Electronic apex locator; Odontometry; Primary teeth; Tooth apex; Working length.