Effects of functional orthopedic treatment on mandibular trabecular bone in class II patients using fractal analysis

Investigation of changes caused by Rapid Maxillary Expansion in mandibular bone and temporomandibular joint trabecular structure using fractal analysis

BACKGROUND

The aim of this study is to evaluate the changes in the trabecular structure of the mandibular bone and temporomandibular joint following Rapid Maxillary Expansion.

METHODS

Thirty-nine patients who received Rapid Maxillary Expansion treatment in the Department of Orthodontics of the Faculty of Dentistry were selected from the archieve for the study. Trabecular structure changes of the angulus mandible, corpus mandible, and condyle regions were examined using fractal analysis on the dental panoramic radiographs. Radiographs taken before the treatment (T0) and at the end of the 3-month retention period (T1) of the patients.

RESULTS

There was no statistically significant difference between T0 and T1 in the condyle, ramus mandible, and corpus mandible regions depending on time and sex. (p < 0.05) CONCLUSION: The results of this study showed that Rapid Maxillary Expansion treatment does not have a significant impact on the trabecular structure of the mandible and temporomandibular joint depending on time and gender.

Effect of Fixed and Removable Functional Therapy on Mandibular Anterior Bone Structures: A Fractal Analysis Study

(1) Background and aim: The effects of functional therapies on dentoalveolar and skeletal structures have been investigated in orthodontics for many years. The aim of this retrospective study was to evaluate the changes caused by fixed and removable functional therapy in the mandibular anterior trabecular structures using fractal dimension (FD) analysis. (2) Methods: A total of 60 patients with skeletal and dental class II malocclusion were included in the study and three groups were formed: the untreated control group (CG), the Forsus fatigue-resistant device group (FFRDG), and the Monoblock group (MBG). Bone areas of interest determined in the buccoapical of the mandibular incisors and the symphysis in the lateral cephalometric radiographs taken before (T0) and after (T1) functional therapy were evaluated using FD analysis. The relationship between the FD and IMPA (Incisor Mandibular Plane Angle) angles was evaluated. Parametric and nonparametric tests were used in statistical analysis according to normality distribution. The statistical significance level was determined as p < 0.05. (3) Results: There was no statistically significant difference between the FD values of all groups at T0 (p > 0.05). At T1, buccoapical FD values were significantly lower in FFRDG and MBG compared to the control group (p < 0.05), while symphyseal FD values were not found to be significant (p > 0.05). The IMPA angle was significantly lower in the FFRDG and MBG than in the control group at T0, while it was higher at T1 (p < 0.05). While a significant negative correlation was observed between the IMPA angle and buccoapical FD values in both FFRDG and MBG (p < 0.05), it was not observed with the symphysis FD values (p > 0.05). (4) Conclusions: Trabecular changes caused by functional therapy in the mandibular anterior bone can be evaluated on lateral cephalometric radiographs with FD analysis. It was concluded that orthodontists should ensure controlled changes in the IMPA angle during functional therapy, especially for the decreases in FDs seen in the buccoapical alveolar region due to the forward movement of the mandibular incisors.

The effect of mentoplate application on the condyle

BACKGROUND

The aim of the study was to investigate the changes occurring in the mandibular condyle by using mentoplate together with rapid maxillary expansion (MP-RME) treatment in the correction of skeletal class III relationship, using fractal analysis (FA).

METHODS

The sample consisted of 30 individuals (8-11 years) diagnosed with skeletal Class III malocclusion who underwent MP-RME treatment. Archival records provided cone-beam computed tomography (CBCT) images taken at two intervals: before MP-RME treatment (T0) and after treatment (T1). The CBCT images were obtained using standardized settings to ensure consistency in image quality and resolution. The trabecular structures in the bilateral condyles at both T0 and T1 were analyzed using FA. The FA was performed on these condylar images using the Image J software. The region of interest (ROI) was carefully selected in the condyle to avoid overlapping with cortical bone, and the box-counting method was employed to calculate the fractal dimension (FD). Statistical analysis was conducted to compare the FD values between T0 and T1 and to evaluate gender differences. The statistical significance was determined using paired t-tests for intra-group comparisons and independent t-tests for inter-group comparisons, with a significance level set at p < 0.05.

RESULTS

The analysis revealed no statistically significant differences in the trabecular structures of the condyles between T0 and T1 (p > 0.05). However, a significant gender difference was observed in FA values, with males exhibiting higher FA values in the left condyle compared to females at both T0 and T1 (p < 0.05). Specifically, the FA values in the left condyle increased from a mean of 1.09 ± 0.09 at T0 to 1.13 ± 0.08 at T1 in males, whereas in females, the FA values remained relatively stable with a mean of 1 ± 0.09 at T0 and 1.03 ± 0.11 at T1.

CONCLUSION

The findings indicate that MP-RME therapy does not induce significant alterations in the trabecular structure of the mandibular condyle. These results suggest the treatment's safety concerning the structural integrity of the condyle, although the observed gender differences in FA values warrant further investigation.

Evaluation of mandibular osseous structure in patients with mandibular asymmetry: a fractal analysis study

OBJECTIVE

We evaluated the effect of mandibular asymmetry on the trabecular structure of the mandible as measured through fractal analysis (FA).

STUDY DESIGN

We divided a sample of 105 patients with skeletal class I occlusion, cervical vertebral maturation CS6, and skeletal vertical dimension ratios within normal limits into right asymmetric, left asymmetric, and symmetric groups. We performed FA on 6 bilateral regions of interest on panoramic radiographs of the patients and calculated the mean fractal dimension (FD) for each region. We performed the Wilcoxon signed-rank and paired t tests to compare the significance of differences in FD between sides within each group and between groups for all regions. Statistical significance was established at P < .05.

RESULTS

We found statistically significant differences in mean FD values between the right and left condyles of the 2 asymmetric patient groups. The FD was greater in the left condyle of patients with right asymmetry and in the right condyle of patients with left asymmetry. The right condyle had a significantly greater FD in left asymmetric patients than in right asymmetric patients.

CONCLUSIONS

The results of FA indicate that asymmetry is characterized by an increase in the mean FD of the condyle that is responsible for the asymmetry. Fractal analysis can be a valuable diagnostic technique in distinguishing trabecular differences in the condylar areas of asymmetric individuals.

Evaluation of trabecular changes following advancement genioplasty combined with or without bilateral sagittal split osteotomy by fractal analysis: a retrospective cohort study

BACKGROUND

It is aimed to investigate whether there was a difference in radiographic changes in the operational areas between genioplasty alone and genioplasty combined with mandibular advancement and to evaluate the fractal dimension (FD) to assess trabecular changes after genioplasty surgery.

METHODS

Preoperative-(T0) and postoperative-(T1) panoramic radiographs of 26 patients without any complications who underwent genioplasty combined with bilateral sagittal osteotomy and mandibular advancement or genioplasty alone were selected. In the panoramic radiographs of both groups, the genial segment, mandibular angulus, and surgical osteotomy line were examined using FD. The box-counting method was used for FD evaluation.

RESULTS

It was determined that FD values before and after treatment were similar in both groups for all regions where measurements were made. After surgery, the FD values of the middle region of the genial segment were found to be significantly lower than the other regions. At T1, the FD values at the osteotomy area were found to be significantly higher than those in the middle region of the genial segment.

CONCLUSION

Trabecular structure does not differ in patients undergoing genioplasty alone or in combination with mandibular advancement osteotomy. The middle region of the genial segment heals later than other regions.

Evaluating the effects of orthodontic treatment with clear aligners and conventional brackets on mandibular condyle bone quality using fractal dimension analysis of panoramic radiographs

OBJECTIVE

Orthodontic treatment carried out with clear aligners has become a method that is preferred by patients. In this study, the effect following orthodontic treatment with clear aligners and with conventional brackets, on the mandibular condyle trabecular bone formation is aimed to be examined.

MATERIALS AND METHODS

Thirty two individuals (16 females and 16 males) with a mean age of 16.80 ± 3,10 years who received orthodontic treatment with clear aligners and conventional brackets were included in the study. Individuals included in the study from the archive data were divided into two groups according to treatment types. The mandibular condyle bone quality in the panoramic images taken from the patients before orthodontic treatment (T0) and after orthodontic treatment (T1) has been compared retrospectively. This examination is carried out via the fractal analysis method.

RESULT

The mandibular condyle bone density in individuals that have undergone orthodontic treatment with clear aligners, has been reduced following orthodontic treatment. In individuals that have undergone orthodontic treatment with conventional brackets however the mandibular condyle bone density has increased following treatment (T0) in comparison to before being treated (T1). The mandibular condyle bone density change according to different treatment groups has been found to be statistically different.

CONCLUSION

Orthodontic treatment with clear aligners provides several advantages to patients. However, besides determining the effectiveness of the treatment, complications must also be examined. Application of clear aligners in orthodontic treatment may cause a decrease in bone density in the mandibular condyle. When evaluating orthodontic treatments carried out with clear aligners, the change of the mandibular condyle head bone should be taken into consideration.