Pulpotomi Tedavisinin Alveolar Kemiğe Olan Etkisinin Fraktal Analiz Kullanılarak Değerlendirilmesi

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

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