Büşra DEMİR ÇİÇEK, Orhan ÇİÇEK, Ahmet YILDIRIM
Turkish Endodontic Journal - 2026;11(2):208-217
Purpose: To assess periapical trabeculation of endodontically treated mandibular first molars before (T0) and after (T1) orthodontic treatment using fractal dimension (FD) analysis, and the effect of sex on these changes. Methods: The study included 32 patients (15 males and 17 females, mean age 17.32+/-1.71 years). The study group consisted of endodontically treated teeth, and their healthy contralateral counterparts served as controls. FD analysis was performed on 40x40 pixel ROIs from panoramic radiographs at T0 and T1. Paired t-tests were used for comparisons between the study group and their contralateral controls, as well as for T0-T1 comparisons. Independent t-tests were used to evaluate sex-related differences (p<0.05). Results: FD values of the study group were significantly lower than controls at T0 and T1 (p<0.001), with a greater T0-T1 increase in the study group. At T0, female FD values were significantly lower than males in the study group (p=0.014), but this difference was not significant at T1 (p>0.05). Significant T0-T1 FD increases were observed in both sexes and groups (p<0.05). Conclusion: Periapical trabeculation during the healing of endodontically treated teeth was not adversely affected by orthodontic treatment, and sex-related differences tend to balance over time.
