Pulpotomi Tedavisinin Alveolar Kemiğe Olan Etkisinin Fraktal Analiz Kullanılarak Değerlendirilmesi

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Objective: In permanent teeth, successful pulpotomy treatments can be performed using

calcium silicate-based pulpotomy agents in cases of severe caries that progress to the pulp,

causing pulp inflammation. It is thought that one of the important long-term outcomes of this

treatment option is the maintenance of alveolar bone health. Therefore, the aim of this study is

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to investigate changes in the periapical bone using fractal dimension (FD) in the panoramic

radiographs of patients who underwent coronal pulpotomy treatment on their mandibular first

molars. Materials and Methods: Of the 153 patients who underwent pulpotomy treatment on

their mandibular first molars, 20 patients were included who had at least two years of follow-

up panoramic radiographs and had a first molar on one side of the mandible that was either

caries-free or had caries at the enamel level. The first molars that were considered healthy in

the patients' pre-treatment and follow-up radiographs and that were initially decayed and

subsequently underwent pulpotomy were selected (split-mouth). Square areas of 30x30 pixels

were created from the region between the roots, 1 mm below the apical regions of the teeth.

Fractal analysis was performed on these areas using ImageJ v1.54 software. Results: The

analyses revealed no statistically significant difference between the fractal analyses of the first

molars without caries or with enamel-level caries in the patients' pre-treatment radiographs and

those with caries (p>0.05). A statistically significant difference was found between the fractal

analyses of the first molars with no caries or enamel-level caries in the follow-up radiographs

taken at least 2 years later and the teeth that underwent pulpotomy treatment (p<0.05). The

analysis results were higher in teeth that underwent pulpotomy treatment compared to the other

side. Conclusion: Pulpotomy treatments applied to young permanent teeth also have positive

effects on alveolar bone health in the long term.

Keywords: Keywords: Pulpotomy; Fractal analysis; Alveolar bone health

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