ASSESSING PERIAPICAL BONE HEALING VIA FRACTAL ANALYSIS: CALCIUM HYDROXIDE VS. TRICALCIUM SILICATE SEALERS IN SINGLE-VISIT ROOT CANAL TREATMENT Fraktal Analiz ile Periapikal Kemik İyileşmesinin Değerlendirilmesi: Tek Seanslı Kök Kanal Tedavisinde Kalsiyum Hidroksit ve Trikalsiyum Silikat Patların Karşılaştırılması

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Gülderen Ö., SARIÇAM E.

Journal of Kirikkale University Faculty of Medicine, cilt.28, sa.2, ss.175-180, 2026 (Scopus, TRDizin)

Özet

Objective: This study aimed to compare the effectiveness of two root canal sealers, Sealapex (calcium hydroxide-based) and AH plus bioceramic (tricalcium silicate-based), in promoting periapical healing following single-visit endodontic treatment, utilizing fractal analysis as a quantitative assessment tool. Material and Methods: A retrospective analysis was conducted on periapical radiographs of 14 mandibular molars with periapical lesions, equally divided into sealapex and AH plus bioceramic groups. In total, 28 roots from 14 mandibular molars were included in the analysis. Fractal analysis was performed on radiographs taken immediately after treatment and at the 3-6-month follow-up to evaluate changes in trabecular bone structure. The box-counting method in ImageJ was used to calculate fractal dimension (FD) values, with statistical analysis performed using dependent and independent t-tests. Statistical significance was set at p<0.05. Results: Both sealers demonstrated significant reductions in FD values over time (dependent t-test; p<0.05), indicating improved periapical healing. However, no statistically significant difference was observed between the two sealers in initial or follow-up FD values (independent t-test; p>0.05). Radiographic regression of lesion size further supported these findings. Conclusion: The study concludes that both sealapex and AH plus bioceramic sealers are equally effective in promoting periapical healing in single-visit endodontic procedures. Fractal analysis serves as a reliable method for quantifying healing outcomes, with no significant superiority of one sealer over the other.