Kübra Gürler, Berkhas Tumani Üstdal, Koray Yılmaz
Turkish Endodontic Journal - 2025;10(3):177-187
Abstract Purpose: The aim of this retrospective study was to evaluate the degree of healing in the periapical region of teeth with chronic apical periodontitis (CAP) following initial root canal treatment (RCT) and retreatment using fractal analysis (FA) of panoramic radiographs after 2-year follow-up. Methods: This study included a total of 136 mandibular molars, 71 initial RCTs and 65 retreatments. Teeth that were diagnosed with CAP and presented with a well-defined radiolucent periapical lesion were included in the study. Both preoperative and 2-year follow-up radiographs of ideal quality were chosen for the analysis. FA was performed using the box-counting method proposed by White and Rudolph using ImageJ 1.3 software (NIH, Bethesda, MD, USA). The data were analyzed using the Kolmogorov-Smirnov, Wilcoxon, and Chi-square tests and Spearman's correlation coefficient. Results: No statistically significant difference was found between the healing rates of the initial RCT and retreatment procedures (p >0.05). There was a statistically significant difference between the fractal dimension values measured before treatment and 2 years after treatment in patients who underwent initial RCT and retreatment procedures (p <0.05). Conclusion: According to the FA results, the healing rate in the periapical region was similar between the initial RCT and retreatment procedures.
