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The Quantitative Method for Following Radiologic Healing in Endodontic Retreatment; 1-Year Follow-up Study

Year 2023, Volume: 26 Issue: 4, 367 - 373, 31.12.2023

Serkan Yılmaz , Salih Düzgün

https://doi.org/10.7126/cumudj.1253545

Abstract

Objectives: This study aimed to quantitatively evaluate the changes in the internal bone structure at the periapical bone regions after retreatment in endodontics using fractal analysis method on periapical radiographs.
Materials and Methods: 29 single-rooted, asymptomatic, single-visit retreatment teeth with apical lesion were included in the study. All teeth included in the study were selected from the maxilla anterior region. Periapical radiograph (T0) was taken for baseline diagnosis at the start of retreatment. Second periapical follow-up radiograph (T1) of the patients was taken at the end of 1 year. The first evaluation phase of the 1-year results of endodontic retreatment is based on the periapical index (PAI). Fractal dimension (FD) was calculated by box-counting method. The paired-sample t-test was used to compare T0 and T1 FDs. The independent samples t-test was employed to compare FD changes between the sexes. The significance level was set to 0.05.
Results: PAI scores were found to be statistically significantly decreased in T1 radiographs compared to T0 (p<0.001). The mean FD value increased statistically significantly in T1 radiographs compared to T0 radiographs (p<0.001). No significant difference was found in the T0 and T1 radiographs of FDs in gender comparison (p>0.05).
Conclusion: At the end of the 1-year follow-up, FD increased in the periapical lesion area, which is interpreted as the healing of the lesions. Fractal analysis is recommended as a method that will benefit clinicians in the follow-up of retreatment recovery.

Keywords

Fractals Retreatment Diagnostic imaging Periapical Periodontitis Radiography

References

  • 1. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009; 35: 930-937. https://doi.org/10.1016/j.joen.2009.04.023
  • 2. de Chevigny C, Dao TT, Basrani BR. et al. Treatment outcome in endodontics: The Toronto study-phase 4: initial treatment. J Endod 2008; 34: 258-263. https://doi.org/10.1016/j.joen.2007.10.017
  • 3. Peters OA, Barbakow F, Peters CI. An analysis of endodontic treatment with three nickel‐titanium rotary root canal preparation techniques. Int Endod J 2004; 37: 849-859. https://doi.org/10.1111/j.1365-2591.2004.00882.x
  • 4. Crozeta BM, Lopes FC, Menezes Silva R, Silva-Sousa YTC, Moretti LF, Sousa-Neto MD. Retreatability of BC Sealer and AH Plus root canal sealers using new supplementary instrumentation protocol during non-surgical endodontic retreatment. Clin Oral Investig 2021; 25: 891-899. https://doi.org/10.1007/s00784-020-03376-4
  • 5. De‐Deus G, Belladonna F, Zuolo A. et al. XP‐endo Finisher R instrument optimizes the removal of root filling remnants in oval‐shaped canals. Int Endod J 2019; 52: 899-907. https://doi.org/10.1111/iej.13077
  • 6. Setzer FC, Lee S-M. Radiology in Endodontics. Dent Clin N Am 2021; 65: 475-486. https://doi.org/10.1016/j.cden.2021.02.004
  • 7. Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J Endod 2008; 34: 1325-1331. https://doi.org/10.1016/j.joen.2008.08.013
  • 8. 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: 181-189. https://doi.org/10.1111/iej.13409
  • 9. Amuk M, Gul Amuk N, Yılmaz S. Treatment and posttreatment effects of Herbst appliance therapy on trabecular structure of the mandible using fractal dimension analysis. Eur J Orthod 2022; 44: 125-133. https://doi.org/10.1093/ejo/cjab048
  • 10. Ozturk G, Dogan S, Gumus H, Soylu E, Sezer AB, Yilmaz S. Consequences of Decompression Treatment with a Special-Made Appliance of Nonsyndromic Odontogenic Cysts in Children. J Oral Maxillofac Surg 2022; 80: 1223-1237 https://doi.org/10.1016/j.joms.2022.03.013
  • 11. 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: 23-28. https://doi.org/10.1007/s11282-018-0321-4
  • 12. Bollen A, Taguchi A, Hujoel P, Hollender L. Fractal dimension on dental radiographs. Dentomaxillofac Radiol 2001; 30: 270-275. https://doi.org/10.1038/sj/dmfr/4600630
  • 13. Kaba YN, Öner Nİ, Amuk M, Bilge S, Soylu E, Demirbaş AE. Evaluation of trabecular bone healing using fractal dimension analysis after augmentation of alveolar crests with autogenous bone grafts: a preliminary study. Oral Radiol 2022; 38: 139-146. https://doi.org/10.1007/s11282-021-00536-4
  • 14. Eninanç İ, Yeler DY, Çınar Z. Investigation of mandibular fractal dimension on digital panoramic radiographs in bruxist individuals. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131: 600-609. https://doi.org/10.1016/j.oooo.2021.01.017
  • 15. 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: 6465-6472. https://doi.org/10.1007/s00784-021-04079-0
  • 16. Ørstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Dent Traumatol 1986; 2: 20-34. https://doi.org/10.1111/j.1600-9657.1986.tb00119.x
  • 17. Tosun S, Karataslioglu E, Tulgar MM, Derindag G. Fractal analysis and periapical index evaluation of multivisit nonsurgical endodontic retreatment: A retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133: 245-251. https://doi.org/10.1016/j.oooo.2021.08.016
  • 18. Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: The Toronto Study. Phase 1: initial treatment. J Endod 2003; 29: 787-793. https://doi.org/10.1097/00004770-200312000-00001
  • 19. 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: 628-635. https://doi.org/10.1016/S1079-2104(99)70097-1
  • 20. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977: 159-174. https://doi.org/10.2307/2529310
  • 21. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15: 155-163. https://doi.org/10.1016/j.jcm.2016.02.012
  • 22. Kurşun-Çakmak EŞ, Bayrak S. Comparison of fractal dimension analysis and panoramic-based radiomorphometric indices in the assessment of mandibular bone changes in patients with type 1 and type 2 diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126: 184-191. https://doi.org/10.1016/j.oooo.2018.04.010
  • 23. 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: 933-937. https://doi.org/10.1002/JPER.19-0452
  • 24. 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: 523-529. https://doi.org/10.1111/iej.12020
  • 25. Swartz DB, Skidmore A, Griffin Jr J. Twenty years of endodontic success and failure. J Endod 1983; 9: 198-202. https://doi.org/10.1016/S0099-2399(83)80092-2

Endodontik Yeniden Tedavilerde Radyolojik İyileşmenin Takibi İçin Kantitatif Yöntem; 1-Yıllık Takip Çalışması

Year 2023, Volume: 26 Issue: 4, 367 - 373, 31.12.2023

Serkan Yılmaz , Salih Düzgün

https://doi.org/10.7126/cumudj.1253545

Abstract

Amaç: Bu çalışmada endodontide retreatment sonrası periapikal kemik bölgelerinde internal kemik yapısında meydana gelen değişikliklerin fraktal analiz yöntemi kullanılarak periapikal radyografiler üzerinde kantitatif olarak değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Çalışmaya apikal lezyonu olan 29 adet tek köklü, asemptomatik, tek seans retreatment yapılan dişler dahil edildi. Çalışmaya dahil edilen tüm dişler maksilla anterior bölgesinden seçilmiştir. Retreatment başlangıcında temel tanı için periapikal radyografi (T0) çekildi. Hastaların 1. yıl sonunda ikinci periapikal kontrol grafileri (T1) çekildi. Endodontik retreatmentın 1 yıllık sonuçlarının ilk değerlendirme aşaması periapikal indekse (PAI) dayalıdır. Fraktal boyut (FB), kutu sayma yöntemiyle hesaplandı. The paired-sample t-testi T0 ve T1 FB'leri karşılaştırmak için kullanıldı. Cinsiyetler arasındaki FD değişikliklerini karşılaştırmak için bağımsız örneklem t testi kullanıldı. Anlamlılık düzeyi 0.05 olarak kabul edildi.
Bulgular: PAI skorları T1 grafilerde T0'a göre istatistiksel olarak anlamlı derecede düşük bulundu (p<0.001). Ortalama FB değeri T1 grafilerde T0 grafilere göre istatistiksel olarak anlamlı artış gösterdi (p<0.001). FB'lerin T0 ve T1 grafilerinde cinsiyet karşılaştırmasında anlamlı fark bulunmadı (p>0,05).
Sonuç: 1 yıllık takibin sonunda periapikal lezyon bölgesinde FB artışı lezyonların iyileşmesi olarak yorumlanmaktadır. Fraktal analiz, retreatment sonrası iyileşmenin takibinde klinisyenlere fayda sağlayacak bir yöntem olarak önerilmektedir.

Keywords

Fractals Retreatment Diagnostic imaging Periapical Periodontitis Radiography

References

  • 1. Torabinejad M, Corr R, Handysides R, Shabahang S. Outcomes of nonsurgical retreatment and endodontic surgery: a systematic review. J Endod. 2009; 35: 930-937. https://doi.org/10.1016/j.joen.2009.04.023
  • 2. de Chevigny C, Dao TT, Basrani BR. et al. Treatment outcome in endodontics: The Toronto study-phase 4: initial treatment. J Endod 2008; 34: 258-263. https://doi.org/10.1016/j.joen.2007.10.017
  • 3. Peters OA, Barbakow F, Peters CI. An analysis of endodontic treatment with three nickel‐titanium rotary root canal preparation techniques. Int Endod J 2004; 37: 849-859. https://doi.org/10.1111/j.1365-2591.2004.00882.x
  • 4. Crozeta BM, Lopes FC, Menezes Silva R, Silva-Sousa YTC, Moretti LF, Sousa-Neto MD. Retreatability of BC Sealer and AH Plus root canal sealers using new supplementary instrumentation protocol during non-surgical endodontic retreatment. Clin Oral Investig 2021; 25: 891-899. https://doi.org/10.1007/s00784-020-03376-4
  • 5. De‐Deus G, Belladonna F, Zuolo A. et al. XP‐endo Finisher R instrument optimizes the removal of root filling remnants in oval‐shaped canals. Int Endod J 2019; 52: 899-907. https://doi.org/10.1111/iej.13077
  • 6. Setzer FC, Lee S-M. Radiology in Endodontics. Dent Clin N Am 2021; 65: 475-486. https://doi.org/10.1016/j.cden.2021.02.004
  • 7. Estrela C, Bueno MR, Azevedo BC, Azevedo JR, Pécora JD. A new periapical index based on cone beam computed tomography. J Endod 2008; 34: 1325-1331. https://doi.org/10.1016/j.joen.2008.08.013
  • 8. 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: 181-189. https://doi.org/10.1111/iej.13409
  • 9. Amuk M, Gul Amuk N, Yılmaz S. Treatment and posttreatment effects of Herbst appliance therapy on trabecular structure of the mandible using fractal dimension analysis. Eur J Orthod 2022; 44: 125-133. https://doi.org/10.1093/ejo/cjab048
  • 10. Ozturk G, Dogan S, Gumus H, Soylu E, Sezer AB, Yilmaz S. Consequences of Decompression Treatment with a Special-Made Appliance of Nonsyndromic Odontogenic Cysts in Children. J Oral Maxillofac Surg 2022; 80: 1223-1237 https://doi.org/10.1016/j.joms.2022.03.013
  • 11. 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: 23-28. https://doi.org/10.1007/s11282-018-0321-4
  • 12. Bollen A, Taguchi A, Hujoel P, Hollender L. Fractal dimension on dental radiographs. Dentomaxillofac Radiol 2001; 30: 270-275. https://doi.org/10.1038/sj/dmfr/4600630
  • 13. Kaba YN, Öner Nİ, Amuk M, Bilge S, Soylu E, Demirbaş AE. Evaluation of trabecular bone healing using fractal dimension analysis after augmentation of alveolar crests with autogenous bone grafts: a preliminary study. Oral Radiol 2022; 38: 139-146. https://doi.org/10.1007/s11282-021-00536-4
  • 14. Eninanç İ, Yeler DY, Çınar Z. Investigation of mandibular fractal dimension on digital panoramic radiographs in bruxist individuals. Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 131: 600-609. https://doi.org/10.1016/j.oooo.2021.01.017
  • 15. 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: 6465-6472. https://doi.org/10.1007/s00784-021-04079-0
  • 16. Ørstavik D, Kerekes K, Eriksen HM. The periapical index: a scoring system for radiographic assessment of apical periodontitis. Dent Traumatol 1986; 2: 20-34. https://doi.org/10.1111/j.1600-9657.1986.tb00119.x
  • 17. Tosun S, Karataslioglu E, Tulgar MM, Derindag G. Fractal analysis and periapical index evaluation of multivisit nonsurgical endodontic retreatment: A retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 133: 245-251. https://doi.org/10.1016/j.oooo.2021.08.016
  • 18. Friedman S, Abitbol S, Lawrence HP. Treatment outcome in endodontics: The Toronto Study. Phase 1: initial treatment. J Endod 2003; 29: 787-793. https://doi.org/10.1097/00004770-200312000-00001
  • 19. 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: 628-635. https://doi.org/10.1016/S1079-2104(99)70097-1
  • 20. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977: 159-174. https://doi.org/10.2307/2529310
  • 21. Koo TK, Li MY. A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med 2016; 15: 155-163. https://doi.org/10.1016/j.jcm.2016.02.012
  • 22. Kurşun-Çakmak EŞ, Bayrak S. Comparison of fractal dimension analysis and panoramic-based radiomorphometric indices in the assessment of mandibular bone changes in patients with type 1 and type 2 diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126: 184-191. https://doi.org/10.1016/j.oooo.2018.04.010
  • 23. 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: 933-937. https://doi.org/10.1002/JPER.19-0452
  • 24. 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: 523-529. https://doi.org/10.1111/iej.12020
  • 25. Swartz DB, Skidmore A, Griffin Jr J. Twenty years of endodontic success and failure. J Endod 1983; 9: 198-202. https://doi.org/10.1016/S0099-2399(83)80092-2
There are 25 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Serkan Yılmaz 0000-0001-7149-0324

Salih Düzgün 0000-0002-0868-3390

Publication Date December 31, 2023
Submission Date February 20, 2023
Published in Issue Year 2023Volume: 26 Issue: 4

Cite

EndNote Yılmaz S, Düzgün S (December 1, 2023) The Quantitative Method for Following Radiologic Healing in Endodontic Retreatment; 1-Year Follow-up Study. Cumhuriyet Dental Journal 26 4 367–373.
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