de Oliveira Carla Barros, Rocha Thaiza Gonçalves, Pintor Andrea Vaz Braga, Magno Marcela Baraúna, Abrahão Aline Corrêa, Maia Lucianne Cople, Romañach Mário José, Visconti Maria Augusta
Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Imaging Sci Dent. 2025 Jun;55(2):126-138. doi: 10.5624/isd.20240221. Epub 2025 Apr 10.
This study aimed to review, evaluate, and synthesize existing evidence on the effectiveness of fractal analysis (FA) in assessing bone formation in periapical lesions following endodontic treatment.
Two reviewers systematically searched 6 electronic databases and gray literature. Studies were deemed eligible if they implemented the desired intervention and included a follow-up period of at least 12 months. Methodological quality was assessed using tools from the Joanna Briggs Institute. The meta-analysis calculated the mean difference (MD) in FA measurements of periapical lesion regions before and after endodontic treatment, with subgroup analyses based on bone and treatment type. The GRADE tool was employed to evaluate the certainty of the evidence.
Ten studies were included for qualitative synthesis and 8 in the meta-analysis. Overall, the mean fractal dimension (FD) increased following 12 months of endodontic treatment, with an MD of 0.223 (95% CI: 0.100-0.346; <0.001; I=99%). Subgroup analyses revealed significantly increases in mean FD values for lesions in the maxilla (<0.01) and for the treatment subgroup (<0.01). However, the certainty of evidence was classified as very low.
The observed increase in mean FD 12 months post-endodontic treatment across all included studies indicates bone formation in the periapical lesion regions.
本研究旨在回顾、评估和综合现有证据，以探讨分形分析（FA）在评估根管治疗后根尖周病变骨形成有效性方面的作用。
两名研究者系统检索了6个电子数据库和灰色文献。若研究实施了所需干预措施且随访期至少为12个月，则被视为合格研究。采用乔安娜·布里格斯研究所的工具评估方法学质量。荟萃分析计算了根管治疗前后根尖周病变区域FA测量值的平均差异（MD），并根据骨和治疗类型进行亚组分析。采用GRADE工具评估证据的确定性。
纳入10项研究进行定性综合分析，8项研究纳入荟萃分析。总体而言，根管治疗12个月后平均分形维数（FD）增加，MD为0.223（95%CI：0.100 - 0.346；<0.001；I² = 99%）。亚组分析显示，上颌病变（<0.01）和治疗亚组（<0.01）的平均FD值显著增加。然而，证据的确定性被归类为非常低。
所有纳入研究中观察到的根管治疗后12个月平均FD增加表明根尖周病变区域有骨形成。
