Digital imaging analysis with mathematical morphology and fractal dimension for evaluation of periapical lesions following endodontic treatment.
OBJECTIVE
To see if a method for digitizing trabecular pattern of bone could be used to quantitatively evaluate changes in bone pattern following endodontic treatment of teeth with periapical osteolytic lesions.


METHODS
Periapical radiographs were digitized and further processed with mathematical morphology operations known as skeletonization. The trabecular patterns resulting from this skeletonization process were further analyzed with fractal dimension analysis using box-counting.


RESULTS
The periapical area in digitized radiographic images showed fractal behavior. Twenty-five of 27 patients showed increase of the fractal dimension after root canal treatment. Significant changes of the box-counting could be noted 3 months after root canal treatment (P < .05).


CONCLUSIONS
Mathematical morphology operation and box-counting might be helpful in early detection of changes of periapical trabecular pattern after root canal treatment.
Chen
Ssu-Kuang
SK
School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan. cskchen@ntu.edu.tw
Oviir
Tiina
T
Lin
Chi-Hao
CH
Leu
Liang-Jenq
LJ
Cho
Bong-Hae
BH
Hollender
Lars
L
D000328:Adult; D000465:Algorithms; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging*; D000539:Alveolar Process / Q000000981:diagnostic imaging; D017709:Fractals; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods; D011858:Radiographic Magnification; D019252:Radiography, Dental, Digital / Q000379:methods*; D015203:Reproducibility of Results; D012390:Root Canal Therapy; D018709:Statistics, Nonparametric; D014092:Tooth Root / Q000000981:diagnostic imaging