Endodontik tedavi sonrası periapikal reaktif kemiğin fraktal boyut analizi ile değerlendirilmesi

Amaç: Bu retrospektif çalışmanın amacı; periapikal lezyonlu dişlerin kök kanal tedavisi (KKT) öncesi ve sonrası uzun dö- nem takipleri sonucu değişen fraktal boyut (FB) değerlerini karşılaştırarak iyileşme dönemindeki kemik remodelasyonu- nun FB’a etkisini değerlendirmektir. Bu amaçla, KKT uygu- lanan hastaların pre-op ve post-op panoramik radyografileri üzerinde FB analizi yapılmıştır. Gereç ve Yöntem: Sistemik ya da periodontal problemi olma- yan, asemptomatik apikal periodontitis ya da fistülü bulunan, 2 mm’den büyük 5 mm’den küçük, sınırları belirgin periapikal lezyonların söz konusu olduğu kök kanal tedavileri tamamlan- mış 20 vaka çalışmaya dahil edilmiştir. Tedavi öncesi ve teda- viden 1 yıl sonra alınan panoramikler üzerinde ilgili diş bölge- sinde White and Rudolph tarafından tasarlanan yöntem ile FB analizi gerçekleştirildi. Bulgular: FB sonucu elde edilen tedavi öncesi ortalama FB değeri 1,4054, KKT’den 1 yıl sonra alınan takip radyografile- rinden elde edilen ortalama FB değeri 1,3660 idi. KKT öncesi ve sonrasında hastalardan alınan panoramik radyografilerde apikal lezyonun komşuluğundaki trabeküler kemiğin mikro yapısı FB metoduyla değerlendirilmiş ve sonuçlar istatistiksel olarak anlamlı bulunmuştur. Sonuç: Periapikal iyileşmenin takibinde FB analizinin faydalı bir yöntem olduğu söylenebilir ancak üç boyutlu görüntüle- me kullanılarak yeni çalışmaların yapılması daha faydalı ola- caktır.

Assessment of periapical reactive bone after the endodontic treatment by using fractal dimension analysis

Aim: The present retrospective analysis aims to assess the effect of bone remodeling in the healing period on FD by comparing the fractal dimensions (FD) of teeth, which have periapical lesion, before root canal treatment (RCT) and after long-term follow-up. For this purpose, FD analysis was per- formed on the pre-op and post-op panoramic radiographs of RCT patients. Material and Methods: 20 cases having no systemic or pe- riodontal problem, having asymptomatic apical periodontitis or fistula, having dimension between 2mm and 5mm, having well-circumscribed periapical lesions, and having completed root canal treatment were involved in the study. FD analysis on the teeth by using pre-treatment panoramic radiographs and those taken 1 year after the treatment was performed using the method developed by White and Rudolph Results: The pretreatment value determined using FD was 1.4054, whereas the value obtained from radiograp- hs taken 1 year after RCT was 1.3660. The micro structure of trabecular bone adjacent to the periapical lesion was analyzed with FD method by using panoramic radiograp- hs taken and after RCT and the results were found to be statistically significant. Conclusion: It can be stated that FD analysis is a useful method in monitoring the periapical healing and further studies using 3D imaging would be more beneficial.

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