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Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study

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Abstract

Objective

The aim of this study was to investigate the effects of root-end filling after periapical surgery on the fractal dimension (FD) of the periapical bone.

Methods

Thirty-eight patients who underwent periapical surgery were included in this study. The cases were divided into two subgroups: (1) In the gutta-percha group, root cavity and root-end fillings were not performed after root resection. In this group, there were 14 female patients and 6 male patients. (2) In the mineral trioxide aggregate (MTA) group, the root end was filled with MTA after root resection. In this group, there were 13 female patients and 5 male patients. Each patient underwent two periapical radiographs, one shortly after periapical surgery (10–15 days) and another one 1 year after periapical surgery. Regions of interest (ROIs) located close to the infected root apex were selected for each radiograph. Periapical radiographs were digitized and processed with an FD analysis using the box-counting method.

Results

FD was significantly increased in both groups over time (p < 0.05). The increases in FD between groups were not significant (p > 0.05).

Conclusions

Mathematical morphology combined with the box-counting method showed that the FD change was independent of the root-end filling at the 1-year follow-up after periapical surgery.

Clinical relevance

Because of the complex anatomy of the root canal, orthograde endodontic treatment may be inadequate and periapical surgery becomes an alternative in these cases. In this study, the effect of root-end filling on the increase in trabecular bone after periapical surgery was investigated using fractal analysis.

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References

  1. Christiansen R, Kirkevang LL, Horsted-Bindslev P, Wenzel A (2009) Randomized clinical trial of root-end resection followed by root-end filling with mineral trioxide aggregate or smoothing of the orthograde gutta-percha root filling--1-year follow-up. Int Endod J 42(2):105–114. https://doi.org/10.1111/j.1365-2591.2008.01474.x

    Article  PubMed  Google Scholar 

  2. Walivaara DA, Abrahamsson P, Fogelin M, Isaksson S (2011) Super-EBA and IRM as root-end fillings in periapical surgery with ultrasonic preparation: a prospective randomized clinical study of 206 consecutive teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 112(2):258–263. https://doi.org/10.1016/j.tripleo.2011.01.016

    Article  PubMed  Google Scholar 

  3. von Arx T, Hanni S, Jensen SS (2010) Clinical results with two different methods of root-end preparation and filling in apical surgery: mineral trioxide aggregate and adhesive resin composite. J Endod 36(7):1122–1129. https://doi.org/10.1016/j.joen.2010.03.040

    Article  Google Scholar 

  4. Rapp EL, Brown CE Jr, Newton CW (1991) An analysis of success and failure of apicoectomies. J Endod 17(10):508–512. https://doi.org/10.1016/s0099-2399(06)81800-5

    Article  PubMed  Google Scholar 

  5. De Bruyne MA, De Moor RJ (2009) Long-term sealing ability of Resilon apical root-end fillings. Int Endod J 42(10):884–892. https://doi.org/10.1111/j.1365-2591.2009.01583.x

    Article  PubMed  Google Scholar 

  6. Sauveur G, Sobel M, Boucher Y (2000) Utilization of gutta-percha for retrograde root fillings. Endod Dent Traumatol 16(3):128–131

    Article  PubMed  Google Scholar 

  7. Kruse C, Spin-Neto R, Christiansen R, Wenzel A, Kirkevang LL (2016) Periapical bone healing after apicectomy with and without retrograde root filling with mineral trioxide aggregate: a 6-year follow-up of a randomized controlled trial. J Endod 42(4):533–537. https://doi.org/10.1016/j.joen.2016.01.011

    Article  PubMed  Google Scholar 

  8. Shinbori N, Grama AM, Patel Y, Woodmansey K, He J (2015) Clinical outcome of endodontic microsurgery that uses EndoSequence BC root repair material as the root-end filling material. J Endod 41(5):607–612. https://doi.org/10.1016/j.joen.2014.12.028

    Article  PubMed  Google Scholar 

  9. Zhou W, Zheng Q, Tan X, Song D, Zhang L, Huang D (2017) Comparison of mineral trioxide aggregate and iRoot BP plus root repair material as root-end filling materials in endodontic microsurgery: a prospective randomized controlled study. J Endod 43(1):1–6. https://doi.org/10.1016/j.joen.2016.10.010

    Article  PubMed  Google Scholar 

  10. Chong BS, Pitt Ford TR, Hudson MB (2003) A prospective clinical study of Mineral Trioxide Aggregate and IRM when used as root-end filling materials in endodontic surgery. Int Endod J 36(8):520–526

    Article  PubMed  Google Scholar 

  11. de Chevigny C, Dao TT, Basrani BR, Marquis V, Farzaneh M, Abitbol S, Friedman S (2008) Treatment outcome in endodontics: the Toronto study--phases 3 and 4: orthograde retreatment. J Endod 34(2):131–137. https://doi.org/10.1016/j.joen.2007.11.003

    Article  PubMed  Google Scholar 

  12. Huang CC, Chen JC, Chang YC, Jeng JH, Chen CM (2013) A fractal dimensional approach to successful evaluation of apical healing. Int Endod J 46(6):523–529. https://doi.org/10.1111/iej.12020

    Article  PubMed  Google Scholar 

  13. Gumussoy I, Miloglu O, Cankaya E, Bayrakdar IS (2016) Fractal properties of the trabecular pattern of the mandible in chronic renal failure. Dentomaxillofac Radiol 45(5):20150389

    Article  PubMed  PubMed Central  Google Scholar 

  14. Apolinário AC, Sindeaux R, de Souza Figueiredo PT, Guimarães AT, Acevedo AC, Castro LC, De Paula AP, De Paula LM, De Melo NS, Leite AF (2016) Dental panoramic indices and fractal dimension measurements in osteogenesis imperfecta children under pamidronate treatment. Dentomaxillofac Radiol 45(4):20150400

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yu YY, Chen H, Lin CH, Chen CM, Oviir T, Chen SK, Hollender L (2009) Fractal dimension analysis of periapical reactive bone in response to root canal treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 107(2):283–288. https://doi.org/10.1016/j.tripleo.2008.05.047

    Article  PubMed  Google Scholar 

  16. Li H, Zhai F, Zhang R, Hou B (2014) Evaluation of microsurgery with SuperEBA as root-end filling material for treating post-treatment endodontic disease: a 2-year retrospective study. J Endod 40(3):345–350. https://doi.org/10.1016/j.joen.2013.11.001

    Article  PubMed  Google Scholar 

  17. Rubinstein RA, Kim S (2002) Long-term follow-up of cases considered healed one year after apical microsurgery. J Endod 28(5):378–383. https://doi.org/10.1097/00004770-200205000-00008

    Article  PubMed  Google Scholar 

  18. White SC, Rudolph DJ (1999) Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88(5):628–635

    Article  PubMed  Google Scholar 

  19. von Arx T (2005) The Retroplast Technique. Retrograde obturation with composite and adhesive technique in endodontic surgery. Schweiz Monatsschr Zahnmed 115(12):1190–1203

    Google Scholar 

  20. von Arx T (2005) Failed root canals: the case for apicoectomy (periradicular surgery). J Oral Maxillofac Surg 63(6):832–837. https://doi.org/10.1016/j.joms.2005.02.019

    Article  Google Scholar 

  21. von Arx T, Hanni S, Jensen SS (2014) 5-year results comparing mineral trioxide aggregate and adhesive resin composite for root-end sealing in apical surgery. J Endod 40(8):1077–1081. https://doi.org/10.1016/j.joen.2014.04.009

    Article  Google Scholar 

  22. Song M, Kim SG, Lee SJ, Kim B, Kim E (2013) Prognostic factors of clinical outcomes in endodontic microsurgery: a prospective study. J Endod 39(12):1491–1497. https://doi.org/10.1016/j.joen.2013.08.026

    Article  PubMed  Google Scholar 

  23. Demiralp KÖ, Kurşun-Çakmak EŞ, Bayrak S, Akbulut N, Atakan C, Orhan K (2018) Trabecular structure designation using fractal analysis technique on panoramic radiographs of patients with bisphosphonate intake: a preliminary study. Oral Radiol. https://doi.org/10.1007/s11282-018-0321-4

  24. Arsan B, Köse TE, Çene E, Özcan İ (2017) Assessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 123(3):382–391

    Article  PubMed  Google Scholar 

  25. Jolley L, Majumdar S, Kapila S (2006) Technical factors in fractal analysis of periapical radiographs. Dentomaxillofac Radiol 35(6):393–397. https://doi.org/10.1259/dmfr/30969642

    Article  PubMed  Google Scholar 

  26. Goller Bulut D, Bayrak S, Uyeturk U, Ankarali H (2018) Mandibular indexes and fractal properties on the panoramic radiographs of the patients using aromatase inhibitors. Br J Radiol 91:20180442. https://doi.org/10.1259/bjr.20180442

    Article  PubMed  Google Scholar 

  27. Demirbaş AK, Ergün S, Güneri P, Aktener BO, Boyacıoğlu H (2008) Mandibular bone changes in sickle cell anemia: fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106(1):e41–e48

    Article  PubMed  Google Scholar 

  28. Updike SX, Nowzari H (2008) Fractal analysis of dental radiographs to detect periodontitis-induced trabecular changes. J Periodontal Res 43(6):658–664

    Article  PubMed  Google Scholar 

  29. Kursun-Cakmak ES, Bayrak S (2018) 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. https://doi.org/10.1016/j.oooo.2018.04.010

  30. Demiralp KO, Kursun-Cakmak ES, Bayrak S, Akbulut N, Atakan C, Orhan K (2019) Trabecular structure designation using fractal analysis technique on panoramic radiographs of patients with bisphosphonate intake: a preliminary study. Oral Radiol 35(1):23–28. https://doi.org/10.1007/s11282-018-0321-4

    Article  PubMed  Google Scholar 

  31. von Arx T, Jensen SS, Hanni S (2007) Clinical and radiographic assessment of various predictors for healing outcome 1 year after periapical surgery. J Endod 33(2):123–128. https://doi.org/10.1016/j.joen.2006.10.001

    Article  Google Scholar 

  32. von Arx T, Salvi GE, Janner S, Jensen SS (2009) Gingival recession following apical surgery in the esthetic zone: a clinical study with 70 cases. Eur J Esthet Dent 4(1):28–45

    Google Scholar 

  33. von Arx T, Vinzens-Majaniemi T, Burgin W, Jensen SS (2007) Changes of periodontal parameters following apical surgery: a prospective clinical study of three incision techniques. Int Endod J 40(12):959–969. https://doi.org/10.1111/j.1365-2591.2007.01306.x

    Article  Google Scholar 

  34. Nedderman TA, Hartwell GR, Protell FR (1988) A comparison of root surfaces following apical root resection with various burs: scanning electron microscopic evaluation. J Endod 14(9):423–427

    Article  PubMed  Google Scholar 

  35. Morgan LA, Marshall JG (1998) The topography of root ends resected with fissure burs and refined with two types of finishing burs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 85(5):585–591

    Article  PubMed  Google Scholar 

  36. Weston GD, Moule AJ, Bartold PM (1999) A scanning electron microscopic evaluation of root surfaces and the gutta-percha interface following root-end resection in vitro. Int Endod J 32(6):450–458

    Article  PubMed  Google Scholar 

  37. Marquis VL, Dao T, Farzaneh M, Abitbol S, Friedman S (2006) Treatment outcome in endodontics: the Toronto Study. Phase III: initial treatment. J Endod 32(4):299–306. https://doi.org/10.1016/j.joen.2005.10.050

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Dentistry, Department of Endodontics, Bolu Abant Izzet Baysal University, Bolu, Turkey

    Zeliha Uğur Aydın

  2. Faculty of Dentistry Oral and Maxillofacial Surgery Department, Bolu Abant Izzet Baysal University, Bolu, Turkey

    Orçun Toptaş & Neşet Akay

  3. Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey

    Duygu Göller Bulut

  4. Faculty of Dentistry, Oral and Maxillofacial Surgery Department, Tokat Gaziosmanpasa University, Tokat, Turkey

    Tolgahan Kara & Nihat Akbulut

Authors
  1. Zeliha Uğur Aydın
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  2. Orçun Toptaş
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  3. Duygu Göller Bulut
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  4. Neşet Akay
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Correspondence to Zeliha Uğur Aydın.

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This article does not contain any studies with human participants or animals performed by any of the authors. The study was approved by the Ethics Committee of Bolu Abant Izzet Baysal University, (X). The study was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Uğur Aydın, Z., Toptaş, O., Göller Bulut, D. et al. Effects of root-end filling on the fractal dimension of the periapical bone after periapical surgery: retrospective study. Clin Oral Invest 23, 3645–3651 (2019). https://doi.org/10.1007/s00784-019-02967-0

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  • DOI: https://doi.org/10.1007/s00784-019-02967-0

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