Endodontik Tedavi Sonrası Takip Verilerinin Fraktal Boyut Analizi: Retrospektif Bir Çalışma
Year 2024,
Volume: 3 Issue: 3, 122 - 129, 31.12.2024
Özge Kurt
,
Sümeyye Koyuncu
,
Melike Güleç
,
Emine Şimşek
Abstract
Amaç: Endodontik tedavide, periapikal görüntülerden fraktal boyutun ve periapikal indeksin ölçülmesi, hem periapikal kemik değişikliklerinin belirlenmesinde hem de apikal periodontitisin değerlendirilmesinde önemli bir kanıttır. Bu çalışmanın amacı da, endodontik tedavi sonrası periapikal bölgede gözlenen değişiklikleri fraktal analiz yöntemi kullanarak ve periapikal indeksi ölçerek değerlendirmektir.
Gereç ve Yöntemler: Çalışmaya periradiküler cerrahi endikasyonu olmayan dişlere sahip, 16-57 yaş arasında hastalar dahil edildi. Endodontik tedavi uygulanan hastaların başlangıç ve kontrol radyograflarına bakılarak klinik ve radyolojik verileri değerlendirildi. Kök kanal tedavisi öncesi ve 1 yıllık takip sonrası elde edilen periapikal görüntüler üzerinde lezyon merkezi ve çevre reaktif kemikten olacak şekilde 30x30 piksel boyutlarında ilgi alanı seçimi yapıldı. Sonrasında seçilen alanlar üzerinde fraktal boyut kutu sayma yöntemi kullanılarak ölçüldü. Aynı radyografiler üzerinde periapikal indeks değerleri, iyileşmiş (PAI<3) veya iyileşmemiş (PAI≥3) olarak sınıflandırıldı.
Bulgular: Ortalama Fraktal boyut değeri 1 yıllık takipte başlangıca göre anlamlı derecede arttı. Periapikal indeks başlangıç ölçümü ise anlamlı derecede daha yüksek bulundu.
Sonuç: Endodontik tedaviden 1 yıl sonra, Fraktal boyut verilerinin ve periapikal indeks değerlerinin ortaya koyduğu gibi, radyografik olarak periapikal dokularda iyileşme gözlendi. Klinik olarak anlamı, periapikal dokuların takibinde Fraktal boyut analizi ile birlikte periapikal indeks ölçümünün yapılması faydalı bir yöntem olabilir, ancak üç boyutlu görüntüleme yöntemleri ile daha uzun süren takiplerle yeni çalışmaların yapılması gerekmekt
Üstedir.
References
- 1. Patel S, Durack C. Radiology of apical periodontitis, Essential Endodontology: Prevention and Treatment of Apical Periodontitis. John Wiley & Sons Ltd., London, 2019, p179-210.
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- 3. Shrout MK, Potter BJ, Hildebolt CF. The effect of image variations on fractal dimension calculations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84: 96-100.
- 4. Aktuna Belgin C, Serindere G. Evaluation of trabecular bone changes in patients with periodontitis using fractal analysis: a periapical radiography study. J Periodontol. 2020;91:933-7.
- 5. Gill G, Bhuyan A, Kalita C, Das L, Kataki R, Bhuyan D. Single versus multi-visit endodontic treatment of teeth with apical periodontitis: an in vivo study with 1-year evaluation. Ann Med Health Sci Res. 2016;6:19-26.
- 6. Soikkonen K. Endodontically treated teeth and periapical findings in the elderly. Int Endod J. 1995;28:200-3.
- 7. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:628-35.
- 8. Ørstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Dent Traumatol. 1986;2:20-34.
- 9. Zandi H, Petronijevic N, Mdala I, Ibrahimu Mdala, Kristoffersen A, Enersen M, Rôças I. Outcome of endodontic retreatment using 2 root canal irrigant sand influence of infection on healing as determined by a molecular method: a randomized clinical trial. J Endod. 2019;45:1089-98.
- 10. Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment. J Endod. 2003;29:787-93.
- 11. Jolley L, Majumdar S, Kapila S. Technical factors in fractal analysis of periapical radiographs. Dentomaxillofacial Radiol. 2006;35:393-7.
- 12. Aydın ZU, Toptaş O, Bulut DG, Akay N, Kara T, Akbulut N. Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study. Clin Oral Investig. 2019;23:3645-51.
- 13. Huang C, Chen J, Chang Y, Jeng J, Chen C. A fractal dimensional approach to successful evaluation of apical healing. Int Endod J. 2013;46:523-9.
- 14. Uğur Aydın Z, Ocak M, Bayrak S, Göller Bulut D, Orhan K. The effect of type 2 diabetes mellitus on changes in the fractal dimension of periapical lesion in teeth after root canal treatment: a fractal analysis study. Int Endod J. 2021;54:181-9.
- 15. Chugal N, Mallya SM, Kahler B, Lin LM. Endodontic treatment outcomes. Dent Clin North Am. 2017;61:59-80.
- 16. Cakur B, Şahin A, Dagistan S, Altun O, Caglayan F, Miloglu Ö, Harorli A. Dental panoramic radiography in the diagnosis of osteoporosis. J Inter Med Res. 2008;36:792-9.
- 17. Saeed SS, Ibraheem UM, Alnema MM. Quantitative analysis by pixel intensity and fractal dimensions for imaging diagnosis of periapical lesions. Inter J Enhanced Res Sci Technol Eng. 2014;3:138-44.
- 18. Bollen A, Taguchi A, Hujoel P, Hollender L. Fractal dimension on dental radiographs. Dentomaxillofacial Radiol. 2001;30:270-5.
- 19. Arsan B, Köse TE, Çene E, Özcan İ. Assessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123:382-91.
- 20. Gumussoy I, Miloglu O, Cankaya E, Bayrakdar IS. Fractal properties of the trabecular pattern of the mandible in chronic renal. Dentomaxillofacial Radiol. 2016;45:20150389.
- 21. Ay S, Gursoy UK, Erselcan T, Marakoglu I. Assessment of mandibular bone mineral density in patients with type 2 diabetes. Dentomaxillofacial Radiol. 2005;34:327-31.
- 22. Demiralp KÖ, Kurşun-Çakmak EŞ, Bayrak S, Akbulut N, Atakan C, Orhan K. Trabecular structure designation using fractal analysis technique on panoramic radiographs of patients with bisphosphonate intake: a preliminary study. Oral Radiol. 2019;35:23-8.
- 23. Göller Bulut D, Bayrak S, Uyeturk U, Ankarali H. Mandibular indexes and fractal properties on the panoramic radiographs of the patients using aromatase inhibitors. Br J Radiol. 2018;91:20180442.
- 24. Suer BT, Yaman Z, Buyuksarac B. Correlation of fractal dimension values with implant insertion torque and resonance frequency values at implant recipient sites. Int J Oral Maxillofac Implants. 2016;31:55-62.
- 25. Griggs JA. Using fractal geometry to examine failed implants and prostheses. Dent Mater. 2018;34:1748-55.
- 26. Tosun S, Karataslioglu E, Tulgar MM, Derindag G. Retrospective fractal analyses of one-year follow-up data obtained after single-visit nonsurgical endodontic retreatment on periapical radiographs. Clin Oral Investig. 2021;25:6465-72.
- 27. Chen SK, Oviir T, Lin CH, Leu LJ, Cho BH, Hollender L. Digital imaging analysis with mathematical morphology and fractal dimension for evaluation of periapical lesions following endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:467-72.
- 28. YY Yu, H Chen, CH Lin, CM Chen, T Oviir, Chen SK. Fractal dimension analysis of periapical reactive bone in response to root canal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:283-8.
- 29. Hayek E, Aoun G, Bassit R, Nasseh I. Correlating radiographic fractal analysis at implant recipient sites with primary implant stability: an in vivo preliminary study. Cureus. 2020;12:e6539.
- 30. Shrout M, Farley B, Patt S, Potter B, Hildebolt C, Pilgram T, Yokoyama-Crothers N, Dotson M, Hauser J, Cohen S. The effect of region of interest variations on morphologic operations data and gray-level value sex traced from digitized dental radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:636-9.
- 31. Baksi BG, Fidler A. Fractal analysis of periapical bone from lossy compressed radiographs: a comparison of two lossy compression methods. J Digit Imaging. 2011;24:993-8.
- 32. Amer ME, Heo M-S, Brooks SL, Benavides E. Anatomical variations of trabecular bone structure in intraoral radiographs using fractal and particles count analyses. Imaging Sci Dent. 2012;42:5-12.
- 33. Ling H, Yang X, Li P, Megalo Oikonomou V, Xu Y, Yang J. Cross gender-age trabecular texture analysis in cone beam CT. Dentomaxillofacial Radiol. 2014;43:20130324.
Fractal Dimensional Analysis of Follow-Up Data After Endodontic Treatment: A Retrospective Study
Year 2024,
Volume: 3 Issue: 3, 122 - 129, 31.12.2024
Özge Kurt
,
Sümeyye Koyuncu
,
Melike Güleç
,
Emine Şimşek
Abstract
Objective: In endodontic treatment, measuring the fractal dimension and periapical index from periapical images is important evidence in both determining periapical bone changes and evaluating apical periodontitis. The aim of this study is to evaluate the changes observed in the periapical region after endodontic treatment by using the fractal analysis method and measuring the periapical index.
Material and Methods: Patients between the ages of 16 and 57 with teeth without indication for periradicular surgery were included in the study. Clinical and radiological data were evaluated by looking at the initial and control radiographs of the patients who underwent endodontic treatment. On the periapical images obtained before root canal treatment and after 1 year of follow-up, an area of interest of 30x30 pixels was selected, with the lesion center and the surrounding area consisting of reactive bone. Afterwards, the fractal dimension was measured on the selected areas using the box counting method. Periapical index values on the same radiographs were classified as healed (PAI<3) or unhealed (PAI≥3).
Results: The mean Fractal dimension value increased significantly at 1-year follow-up compared to baseline. The periapical index initial measurement was found to be significantly higher.
Conclusion: One year after endodontic treatment, healing of the periapical tissues was observed radiographically, as revealed by fractal dimension data and periapical index values. Clinically, periapical index measurement along with fractal dimension analysis may be a useful method in the follow-up of periapical tissues, but new studies with longer follow-ups using three-dimensional imaging methods need to be conducted.
References
- 1. Patel S, Durack C. Radiology of apical periodontitis, Essential Endodontology: Prevention and Treatment of Apical Periodontitis. John Wiley & Sons Ltd., London, 2019, p179-210.
- 2. Ekert T, Krois J, Meinhold L, Elhennawy K, Emara R, Golla T, Schwendicke F. Deep learning for the radiographic detection of apicallesions. J Endod. 2019;45:917-22.
- 3. Shrout MK, Potter BJ, Hildebolt CF. The effect of image variations on fractal dimension calculations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997;84: 96-100.
- 4. Aktuna Belgin C, Serindere G. Evaluation of trabecular bone changes in patients with periodontitis using fractal analysis: a periapical radiography study. J Periodontol. 2020;91:933-7.
- 5. Gill G, Bhuyan A, Kalita C, Das L, Kataki R, Bhuyan D. Single versus multi-visit endodontic treatment of teeth with apical periodontitis: an in vivo study with 1-year evaluation. Ann Med Health Sci Res. 2016;6:19-26.
- 6. Soikkonen K. Endodontically treated teeth and periapical findings in the elderly. Int Endod J. 1995;28:200-3.
- 7. White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:628-35.
- 8. Ørstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Dent Traumatol. 1986;2:20-34.
- 9. Zandi H, Petronijevic N, Mdala I, Ibrahimu Mdala, Kristoffersen A, Enersen M, Rôças I. Outcome of endodontic retreatment using 2 root canal irrigant sand influence of infection on healing as determined by a molecular method: a randomized clinical trial. J Endod. 2019;45:1089-98.
- 10. Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: the Toronto Study. Phase 1: initial treatment. J Endod. 2003;29:787-93.
- 11. Jolley L, Majumdar S, Kapila S. Technical factors in fractal analysis of periapical radiographs. Dentomaxillofacial Radiol. 2006;35:393-7.
- 12. Aydın ZU, Toptaş O, Bulut DG, Akay N, Kara T, Akbulut N. Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study. Clin Oral Investig. 2019;23:3645-51.
- 13. Huang C, Chen J, Chang Y, Jeng J, Chen C. A fractal dimensional approach to successful evaluation of apical healing. Int Endod J. 2013;46:523-9.
- 14. Uğur Aydın Z, Ocak M, Bayrak S, Göller Bulut D, Orhan K. The effect of type 2 diabetes mellitus on changes in the fractal dimension of periapical lesion in teeth after root canal treatment: a fractal analysis study. Int Endod J. 2021;54:181-9.
- 15. Chugal N, Mallya SM, Kahler B, Lin LM. Endodontic treatment outcomes. Dent Clin North Am. 2017;61:59-80.
- 16. Cakur B, Şahin A, Dagistan S, Altun O, Caglayan F, Miloglu Ö, Harorli A. Dental panoramic radiography in the diagnosis of osteoporosis. J Inter Med Res. 2008;36:792-9.
- 17. Saeed SS, Ibraheem UM, Alnema MM. Quantitative analysis by pixel intensity and fractal dimensions for imaging diagnosis of periapical lesions. Inter J Enhanced Res Sci Technol Eng. 2014;3:138-44.
- 18. Bollen A, Taguchi A, Hujoel P, Hollender L. Fractal dimension on dental radiographs. Dentomaxillofacial Radiol. 2001;30:270-5.
- 19. Arsan B, Köse TE, Çene E, Özcan İ. Assessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017;123:382-91.
- 20. Gumussoy I, Miloglu O, Cankaya E, Bayrakdar IS. Fractal properties of the trabecular pattern of the mandible in chronic renal. Dentomaxillofacial Radiol. 2016;45:20150389.
- 21. Ay S, Gursoy UK, Erselcan T, Marakoglu I. Assessment of mandibular bone mineral density in patients with type 2 diabetes. Dentomaxillofacial Radiol. 2005;34:327-31.
- 22. Demiralp KÖ, Kurşun-Çakmak EŞ, Bayrak S, Akbulut N, Atakan C, Orhan K. Trabecular structure designation using fractal analysis technique on panoramic radiographs of patients with bisphosphonate intake: a preliminary study. Oral Radiol. 2019;35:23-8.
- 23. Göller Bulut D, Bayrak S, Uyeturk U, Ankarali H. Mandibular indexes and fractal properties on the panoramic radiographs of the patients using aromatase inhibitors. Br J Radiol. 2018;91:20180442.
- 24. Suer BT, Yaman Z, Buyuksarac B. Correlation of fractal dimension values with implant insertion torque and resonance frequency values at implant recipient sites. Int J Oral Maxillofac Implants. 2016;31:55-62.
- 25. Griggs JA. Using fractal geometry to examine failed implants and prostheses. Dent Mater. 2018;34:1748-55.
- 26. Tosun S, Karataslioglu E, Tulgar MM, Derindag G. Retrospective fractal analyses of one-year follow-up data obtained after single-visit nonsurgical endodontic retreatment on periapical radiographs. Clin Oral Investig. 2021;25:6465-72.
- 27. Chen SK, Oviir T, Lin CH, Leu LJ, Cho BH, Hollender L. Digital imaging analysis with mathematical morphology and fractal dimension for evaluation of periapical lesions following endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:467-72.
- 28. YY Yu, H Chen, CH Lin, CM Chen, T Oviir, Chen SK. Fractal dimension analysis of periapical reactive bone in response to root canal. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;107:283-8.
- 29. Hayek E, Aoun G, Bassit R, Nasseh I. Correlating radiographic fractal analysis at implant recipient sites with primary implant stability: an in vivo preliminary study. Cureus. 2020;12:e6539.
- 30. Shrout M, Farley B, Patt S, Potter B, Hildebolt C, Pilgram T, Yokoyama-Crothers N, Dotson M, Hauser J, Cohen S. The effect of region of interest variations on morphologic operations data and gray-level value sex traced from digitized dental radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:636-9.
- 31. Baksi BG, Fidler A. Fractal analysis of periapical bone from lossy compressed radiographs: a comparison of two lossy compression methods. J Digit Imaging. 2011;24:993-8.
- 32. Amer ME, Heo M-S, Brooks SL, Benavides E. Anatomical variations of trabecular bone structure in intraoral radiographs using fractal and particles count analyses. Imaging Sci Dent. 2012;42:5-12.
- 33. Ling H, Yang X, Li P, Megalo Oikonomou V, Xu Y, Yang J. Cross gender-age trabecular texture analysis in cone beam CT. Dentomaxillofacial Radiol. 2014;43:20130324.