title: Digital imaging analysis with mathematical morphology and fractal dimension for evaluation of periapical lesions following endodontic treatment.
abstract: 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.
authors.affiliation: School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan. cskchen@ntu.edu.tw
authors.forename: Ssu-Kuang
authors.initials: SK
authors.lastname: Chen
authors.forename: Tiina
authors.initials: T
authors.lastname: Oviir
authors.forename: Chi-Hao
authors.initials: CH
authors.lastname: Lin
authors.forename: Liang-Jenq
authors.initials: LJ
authors.lastname: Leu
authors.forename: Bong-Hae
authors.initials: BH
authors.lastname: Cho
authors.forename: Lars
authors.initials: L
authors.lastname: Hollender
mesh_terms: 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