Evaluation of the Effects of MTA Apexification and Regenerative Endodontic Therapy on Lesion Healing using Fractal Analysis: A Retrospective Study

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ABSTRACT

Aim

A comparison between mineral trioxide aggregate (MTA) apexification and regenerative endodontic therapy (RET) in immature permanent teeth is pivotal for optimising treatment outcomes and enhancing clinical decision-making. Understanding the efficacy, limitations and long-term implications of each approach is essential for achieving predictable, successful outcomes when managing immature teeth with necrotic pulps. The aim of this retrospective study was to compare the changes in the periapical bone using fractal dimension (FD) on the periapical radiographs of patients who underwent apexification and RET.

Material and methods

The lesion area was evaluated using fractal analysis on periapical radiographs obtained before and one year after treatment with the ImageJ program. Additionally, periapical status was classified using the periapical index (PAI). The significance level was set at 0.05.

Results

In both groups, the FD values increased compared with initial values at one-year follow-up after treatment (p > 0.05). There was no statistically significant difference between the groups in terms of the time-dependent changes in FD and PAI (p = 0.798, p = 0.320).

Conclusion

In the present study, we found that the changes in FD and PAI over a one-year observation period were independent of the specific root canal treatment technique used. According to the fractal analysis, neither MTA apexification nor RET with tripleantibiotic paste is superior for immature teeth with pulp necrosis resulting from dental trauma.

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