Avaliação da dimensão fractal do osso alveolar de dentes com lesão endo- periodontal: estudo comparativo em radiografias periapicais

Abstract

The term “endoperiodontal lesion” began to be used to describe lesions in which there is tissue alteration, either in the pulp or in the periodontal tissue, which can interrelate, originating endoperiodontal lesions. Fractal analysis (FA) or fractal dimension (FD) is an objective and quantitative mathematical method used to evaluate complex structures, such as the internal architecture of trabecular bone tissue. It is expressed by numbers that vary between 1 to 2 for two-dimensional images and 2 to 3 for three-dimensional images, with higher values indicating more complex structures. Patients with endo-periodontal lesions in relation to the opposite hemi-arch, in the same region of choice, without endo-periodontal lesions present. X-ray images of 44 patients were evaluated in the Software Image J program, by a single evaluator, who analyzed the endoperiodontal lesions and the analogous region of the contralateral tooth. To avoid visual fatigue and consequent impairment of evaluations, evaluations of a maximum of 20 exams per day were performed. Every 10 days, enough to erase the images, the entire sample was reassessed two more times to calculate the intra- examiner reliability. The regions of interest were determined by dividing the length of the tooth into four. This division was applied from the most cervical point of the lesion, followed by the middle third, lateral apical third and apical third. Of the total sample of 44 patients, 13 (29.5%) were female and 31 (70.5%) were male. The test-t revealed that DF values were statistically significant (p< 0.005) for all comparisons in both sexes. The fractal analysis was able to quantitatively detect differences in the trabecular bone architecture, the side without the presence of endo-periodontal lesion presented a greater complexity of the bone trabeculae than the contralateral side.