Association between dentists' satisfaction and the accuracy of working length measurement on digital periapical radiographs: Study cross-sectional

Gefara Nuha Nazhifa, Felda Noor Sa’ida, Rurie Ratna Shantiningsih, Rini Widyaningrum, Ryna Dwi Yanuaryska, Henny Retno Mayangsari, Rellyca Sola Gracea

Abstract


ABSTRACT

Introduction: Accurate working length measurement is essential for successful endodontic treatment. Digital periapical radiography is widely used for working length determination; however, limited evidence is available regarding dentists' satisfaction with this method and its association with perceived measurement accuracy. This study aimed to investigate the association between dentists’ satisfaction and perceived accuracy of working length measurements obtained using digital periapical radiography, with measurements obtained using an electronic apex locator (EAL) as a comparator. Methods: This cross-sectional study compared 44 paired working length measurements obtained using digital radiographs and an EAL using the Mann–Whitney test. Dentists' satisfaction was evaluated using a questionnaire based on the Technology Acceptance Model (TAM), with validity and reliability assessed using Pearson’s correlation and Cronbach’s alpha, respectively. Spearman’s correlation analyzed the association between satisfaction and perceived accuracy. Results: No statistically significant difference was found between working length measurements obtained using digital periapical radiography and those obtained using an EAL (p>0.05). After excluding two invalid items, the questionnaire demonstrated acceptable validity and reliability. Overall, 60% of respondents were very satisfied and 40% were satisfied with the use of digital periapical radiography for working length determination. Most respondents (67%) perceived the measurement accuracy as moderate, while 33% rated it as high. A significant positive correlation was found between dentists’ satisfaction and perceived measurement accuracy (r=0.662, p=0.007). Conclusion: Dentists' satisfaction was positively associated with their perceived accuracy of working length measurement using digital periapical radiography. Dentists who perceived greater accuracy in working length measurement also reported higher satisfaction with the use of digital periapical radiography. In addition, no significant difference was found between working length measurements obtained using digital periapical radiography and those obtained using an EAL, Suggesting that the two methods yielded comparable measurements under the conditions of this study

KEYWORDS: Endodontics, digital dental radiography, dentist satisfaction, working length, electronic apex locator; technology acceptance model

Hubungan antara kepuasan dokter gigi dan akurasi pengukuran panjang kerja pada radiografi periapikal digital: Studi cross-sectional

ABSTRAK

Pendahuluan: Penentuan panjang kerja yang akurat merupakan salah satu faktor penting dalam keberhasilan perawatan endodontik. Radiografi periapikal digital banyak digunakan untuk menentukan panjang kerja, namun bukti mengenai kepuasan dokter gigi dan hubungannya dengan persepsi terhadap akurasi pengukuran masih terbatas. Penelitian ini bertujuan untuk mengetahui hubungan antara kepuasan dokter gigi dan persepsi terhadap akurasi pengukuran panjang kerja menggunakan radiografi periapikal digital dibandingkan dengan pengukuran menggunakan electronic apex locator (EAL). Metode: Studi potong lintang ini membandingkan 44 pasangan pengukuran panjang kerja dari radiografi digital dan EAL menggunakan uji Mann–Whitney. Kepuasan dokter gigi dievaluasi menggunakan kuesioner berbasis TAM, yang divalidasi melalui korelasi Pearson dan alpha Cronbach. Korelasi Spearman digunakan untuk menganalisis hubungan antara kepuasan dan persepsi akurasi. Hasil: Tidak terdapat perbedaan bermakna antara pengukuran panjang kerja menggunakan radiografi periapikal digital dan EAL (p>0,05). Setelah dua item tidak valid dikeluarkan, kuesioner menunjukkan validitas dan reliabilitas yang dapat diterima. Sebanyak 60% responden sangat puas dan 40% puas terhadap pengukuran panjang kerja secara radiografis. Sebanyak 67% responden menilai akurasi pengukuran sedang dan 33% menilai tinggi. Terdapat korelasi positif yang bermakna antara kepuasan dokter gigi dan persepsi akurasi pengukuran (r=0,662; p=0,007). Simpulan: Hubungan positif ditemukan antara kepuasan dokter gigi dan persepsi mereka terhadap keakuratan penentuan panjang kerja menggunakan radiografi periapikal digital. Dokter gigi yang mempersepsikan tingkat keakuratan penentuan panjang kerja yang lebih tinggi juga melaporkan tingkat kepuasan yang lebih tinggi terhadap penggunaan radiografi periapikal digital. Selain itu, tidak ditemukan perbedaan yang signifikan antara pengukuran panjang kerja yang diperoleh menggunakan radiografi periapikal digital dan pengukuran yang diperoleh menggunakan EAL (Electronic Apex Locator), yang menunjukkan bahwa kedua metode tersebut menghasilkan pengukuran yang sebanding dalam kondisi penelitian ini.

KATA KUNCI: Endodontik; radiografi dental digital; dokter gigi; kepuasan; panjang kerja; electronic apex locator; technology acceptance model.

 


Keywords


Endodontics, digital dental radiography, dentist satisfaction, working length, electronic apex locator; technology acceptance model.

Full Text:

PDF

References


Setzer FC, Li J, Khan AA. The use of artificial intelligence in endodontics. J Dent Res. 2024;103(9). https://doi.org/10.1177/00220345241255593

Kusumawati KY, Yanuaryska RD, Shantiningsih RR. The accuracy of extraoral periapical radiography on determining the working length in endodontic treatment: narrative review. J Radiologi Dentomaksilofasial Indonesia (JRDI). 2022;6(1):8. https://doi.org/10.32793/jrdi.v6i1.770

Rangappa A, Arul B, Somasundaram J, Natanasabapathy V. The precision of radiographic and electronic working length estimation methods in endodontics: A systematic review of clinical studies. Endodontology. 2024;36(4):307–314. DOI: https://doi.org/10.4103/endo.endo_5_24

Bhagat E, Agnihotri Y, Das A, Das S, Panda S, Hota S. Accuracy of an Electronic Apex Locator (EAL) in Measuring the Working Length of Root Canals in Comparison With Radiographs: An In Vivo Study. Cureus. 2024;16(5); https://doi.org/10.7759/cureus.60283

Soerachman B, Sidiqa AN, Endro Wahyudi H. Perbandingan Akurasi Pengukuran Panjang Kerja Menggunakan Metode Radiografi Dan Elektronik Pada Perawatan Endodontik. Jurnal Ilmiah dan Teknologi Kedokteran Gigi (JITEKGI). 2022;18(2):51-6.

Reddy K, Kumar V, Sharma R, Patel S. Evaluation of the efficacy of different systems in determination of root canal working length: A comparative study. World J Dent. 2021;12(5):399–402. https://doi.org/10.5005/jp-journals-10015-1860

Alarifi NA, Alqahtani AM, Alharbi AZ, Alanazi MH, Alanazi AM, Alharbi AF, Alanazi NF, Aloatibi KM, Alatallah FS, Alali HA, Koaban AM. Comparative Accuracy of Electronic Apex Locators and Conventional Radiography for Working Length Determination in Permanent Teeth: A Systematic Review. Cureus. 2025;17(10); https://doi.org/10.7759/cureus.93997

Georgiou P, Vlachou AM, Georgaki M, Angelopoulos C. A literature review on the uncommon use of extraoral periapical radiography. Appl Sci. 2024;14(21):9850. Doi: https://doi.org/10.5005/jp-journals-10015-18600.3390/app14219850

Khan GI, Khan MT, Ehsan S, Fayyaz A, Malik HA, Hussain S. Accuracy of Working Length Measured by Apex Locator and Digital Radiography. Journal of The Pakistan Dental Association. 2021 ;30(1); https://doi.org/10.25301/JPDA.301.24

Dakkaki J, Rouggani FZ, Lahlou M, Mayou R, Ghamrane S, Hamza M, et al. Determination of Working Length in Endodontics: Epidemiological Survey of Dentists in the Private Sector in Casablanca. EC Dental Science. 2022;21:16-31.

Ali A, Bhosale A, Pawar S, Kakti A, Bichpuriya A, Agwan MA, Agwan MA. Current trends in root canal irrigation. Cureus. 2022 ;14(5); https://doi.org/10.7759/cureus.24833

Khanagar SB, Alfadley A, Alfouzan K, Awawdeh M, Alaqla A, Jamleh A. Developments and performance of artificial intelligence models designed for application in endodontics: A systematic review. Diagnostics. 2023 Jan 23;13(3):414; https://doi.org/10.3390/diagnostics13030414

Yen M, Yeung AW. The performance of paralleling technique and bisecting angle technique for taking periapical radiographs: a systematic review. Dentistry Journal. 2023 ;11(7):155; https://doi.org/10.3390/dj11070155

Nekoofar MH. Advances in Working Length Determination. Endodontic Advances and Evidence‐Based Clinical Guidelines. 2022 Sep 22:218-42; https://doi.org/10.1002/9781119553939.ch10

Nurbaiti S, Hadiyani S, Sari DM, Faizah S, Octaviani R, Dawiyah AM. Analisis kepuasan pasien terhadap pelayanan di Instalasi Radiologi: Sebuah tinjauan pustaka. J Radiologi. 2025;1(1):1-8. https://doi.org/10.36729/bi.v16i2.1287

Almutairi M, McKenna G, O’Neill C. Satisfaction with dental care services in Great Britain 1998–2019. BMC Oral Health. 2022;22(1):308; https://doi.org/10.1186/s12903-022-02343-7

El Haiba N, El Hijazi M, Benyahya I. Comparative evaluation of three working length determination techniques: In vitro study. Open Access Libr J. 2026;13(1):e1114912. https://doi.org/10.4236/oalib.1114912

Xu Y, Chen Z, Wang L. Association between telemedicine adoption and physician job satisfaction: Cross-sectional study. J Med Internet Res. 2024;26:e51234. https://doi.org/10.2196/51234

Alshammary F, Alsadoon BK, Altamimi AA, Ilyas M, Hassan I, Alam MK. Perceptions towards use of electronic dental record at a dental college, University of Hail, Kingdom of Saudi Arabia. The J Contemporary Dent Practice. 2021;21(10):1105-12; https://doi.org/10.5005/jp-journals-10024-2891

Lee AT, Ramasamy RK, Subbarao A. Understanding psychosocial barriers to healthcare technology adoption: A review of TAM technology acceptance model and unified theory of acceptance and use of technology and UTAUT frameworks. Healthcare (Basel). 2025;13(3):250. https://doi.org/10.3390/healthcare13030250

Lee JW, Tan JY, Bello F. Technology acceptance model in medical education: systematic review. JMIR Medical Education. 2025 Jul 16;11(1):e67873; https://doi.org/10.2196/67873

Kim J, Kim J, Youn B. Using a Technology Acceptance Model to Explore the Intention to Use Digital Health Technologies Among People With Disabilities: Cross-Sectional Survey Study. J Med Internet Res. 2025;27:e79595. https://doi.org/10.2196/79595

Darmawan AE, Widyaningrum R, Priyono B, Hanindriyo L. Hubungan antara kualitas pelayanan radiografi panoramik dengan tingkat kepuasan pasien: studi cross-sectional. Padjadjaran J Dent Res Stud. 2023;7(3):223-9. https://doi.org/10.24198/pjdrs.v7i3.49745

Ramezani M, Bolbolian M, Aliakbari M, Alizadeh A, Tofangchiha M, Faegh SM, et al. Accuracy of three types of apex locators versus digital periapical radiography for working length determination in maxillary premolars: An in vitro study. Clinics and Practice. 2022 Dec 12;12(6):1043-53; https://doi.org/10.3390/clinpract12060107

Fadlan M, Lahindah L. The Effect of Technology Adoption and Service Quality on Patient Satisfaction (Case Study on Digital Dentistry Adoption at Densthetica Clinic West Sumatra). Dinasti Int. J. Econ. Finance Account. 2025;5(6):6139-48. https://doi.org/10.38035/dijefa.v5i6

Simamora B. Skala Likert, Bias Penggunaan dan Jalan Keluarnya. J Manajemen. 2022;12(1):84-93. https://doi.org/10.46806/jman.v12i1.978

Rodrigues KS, Silva JVM, Cruz AD. Intraoral digital dental radiology in Brazil: challenges and adoption by dentists. Discover Health Systems. 2025;4:128. https://doi.org/10.1007/s44250-025-00307-6

Faraj BM. Root canal curvature as a prognostic factor influencing the diagnostic accuracy of radiographic working length determination and postoperative canal axis modification: an in vitro comparative study. BMC Oral Health. 2021;21(1):90; https://doi.org/10.1186/s12903-021-01446-x

Mourão PS, Fernandes IB, Moreira LV, Machado GF, Falci SGM, de Souza GM, Ramos-Jorge ML. Conventional methods and electronic apical locator in determining working length in different primary teeth: systematic review and meta-analysis of clinical studies. Evid Based Dent. 2025;26:116.

Hendricks JW, Smith A, Peres SC, Sasangohar F. Workers’ acceptance of digital procedures: an application of the technology acceptance model. IISE Transactions on Occupational Ergonomics and Human Factors. 2023;11(1-2):59-68; https://doi.org/10.1080/24725838.2023.2240342

Suparno NR, Faizah A, Zahra HA. Evaluasi Kualitas Radiograf Periapikal Teknik Bisektris: Kesalahan Penempatan Sudut Penyinaran dan Film. Jurnal Imejing Diagnostik (JImeD). 2024;10(1):1–9. https://doi.org/10.31983/jimed.v10i1.10554

Li B, Dudley AG, Lauderdale CJ, Shannon CN, Pope JC. Hidden consequences of patient satisfaction: a survey of pediatric surgeons. J Pediatr Surg. 2021;56(9):1524–1527; https://doi.org/10.1016/j.jpedsurg.2021.03.010

Garabedian PM, Rui A, Volk LA, Neville BA, Lipsitz SR, Healey MJ, et al. A multiyear survey evaluating clinician electronic health record satisfaction. Applied Clinical Informatics. 2023;14(04):632-43; https://doi.org/10.1055/s-0043-1770900

Mühlbacher A, Stolk E. Patient-reported satisfaction, experiences, and preferences: same but different?. Value in Health. 2023;26(1):1-3; https://doi.org/10.1016/j.jval.2022.10.005

Liang H, Xue Y, Zhang ZR. Patient satisfaction in China: a national survey of inpatients and outpatients. BMJ open. 2021 1;11(9):e049570; https://doi.org/10.1136/bmjopen-2021-049570

Dubale AT, Mengestie ND, Tilahun B, Walle AD. User Satisfaction of Using Electronic Medical Record System and Its Associated Factors among Healthcare Professionals in Ethiopia: A Cross‐Sectional Study. BioMed Res Int. 2023;2023(1):4148211; https://doi.org/10.1155/2023/4148211

Kaur G, Thomas AR, Samson RS, Varghese E, Ponraj RR, Nagraj SK, et al. Efficacy of electronic apex locators in comparison with intraoral radiographs in working length determination-a systematic review and meta-analysis. BMC Oral Health. 2024;24(1):532; https://doi.org/10.1186/s12903-024-04259-w

Nabihah KK, Lubis MNP. The correlation of the change in vertical angulation of the beam in the bisecting technique to the length of the tooth. J Radiol Dentomaksilofas Indonesia. 2023;7(1):15–20. https://doi.org/10.32793/jrdi.v7i1.978

Yeung AWK, Wong NSM, Bornstein MM. The performance of paralleling technique and bisecting angle technique for taking periapical radiographs: A systematic review. Dent J. 2023;11(7):155. https://doi.org/10.3390/dj11070155

Suparno NR, Faizah A, Zahra HA. Evaluasi kualitas radiograf periapikal teknik bisektris: Kesalahan penempatan sudut penyinaran dan film. J Imej. 2024;10(1). https://doi.org/10.31983/jimed.v10i1.10554




DOI: https://doi.org/10.24198/pjdrs.v10i2.69994

Refbacks

  • There are currently no refbacks.


 

Creative Commons License All publications by the Universitas Padjadjaran [e-ISSN: 2656-985X p-ISSN: 2656-9868], are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License This license requires that reusers give credit to the creator. It allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, for noncommercial purposes only. 

Visitor Stat