Evaluation of trabecular bone after endodontic treatment in young permanent teeth using fractal analysis

Objective: The aim of our study is to evaluate the time-dependent changes in the fractal dimension (FD) of the periapical bone region after a 1-year follow-up period in necrotic young permanent teeth treated with conventional apexification (CA), one-visit apexification (OA) and regenerative endodontics (RE) at Akdeniz University, Faculty of Dentistry, Department of Pediatric Dentistry, between 2017 and 2022. Method: In this study, a total of 71 teeth with open apices and periapical lesions treated with CA, OA and RE were retrospectively evaluated. In each case, the FD of trabecular bone in the lesion area was calculated using fractal analysis (FA) on periapical radiographs taken before treatment and 1 year after treatment using the box-counting method with Image-J software. The data were statistically analyzed. Results: In all three groups, FD values significantly increased after 1-year follow-up compared to baseline (p<0.05). The time-dependent FD value increase in the OA group was significantly higher than that in the CA group (p<0.05). The time-dependent FD value increase in the RE group was similar to the OA group and higher than the CA group, but this difference between the CA and RE groups was not statistically significant (p>0.05). Conclusion: Our study concluded that the OA method had a higher success rate in periapical healing compared to the CA method, but there was no significant difference between the RE method and the other two methods.