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Yavuz E, Yardimci S. Comparison of periapical radiography, panoramic radiography, and CBCT in the evaluation of trabecular bone structure using fractal analysis. Oral Radiol 2024; 40:394-400. [PMID: 38407759 DOI: 10.1007/s11282-024-00743-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/14/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES The aim of this study is to compare imaging techniques to evaluate trabecular bone structure using Fractal Analysis (FA). METHODS Fifteen sheep hemimandibles were used for this study. Digital images were obtained using periapical radiography, panoramic radiography, and cone-beam computed tomography (CBCT). CBCT imaging was performed in standard (STD) and high-resolution (HR) modes. FA was conducted using ImageJ 1.3 software with the box-counting method on the images. The fractal dimension (FD) values were analyzed by the statistical software Jamovi 1.6.23. Statistical significance was accepted as p < 0.05. RESULTS The highest mean FD value was the FD on digital periapical radiographs (PaFD) (1.28 ± 0.04), and the lowest mean FD value was the FD on standard resolution cone-beam computed tomography images (STD-CBCTFD) (1.12 ± 0.10). Although there was no statistically significant difference between the PaFD and the FD on digital panoramic radiographs (PanFD) (p = 0.485), the PaFD was found to be significantly higher than STD-CBCTFD (p < 0.001), and the FD on high-resolution cone-beam computed tomography images (HR-CBCTFD) (p = 0.007). The PanFD was found to be significantly higher than the STD-CBCTFD (p = 0.004). CONCLUSION According to our results, in the evaluation of trabecular bone structure using FA, periapical radiographs and panoramic radiographs have similar image quality for assessment of the FD. On the other hand, CBCT results did not correlate with results from any of the other techniques in this study.
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Affiliation(s)
- Esra Yavuz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Selmi Yardimci
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Camargo AJ, Rodrigues GA, Munhoz L, Lourenço AG, Watanabe PCA. Are Radiographic Changes in the Mandibular Canal Associated With Bone Mineral Density? J Oral Maxillofac Surg 2024:S0278-2391(24)00577-9. [PMID: 39002553 DOI: 10.1016/j.joms.2024.06.167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 06/14/2024] [Accepted: 06/14/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Osteoporosis, highly prevalent among postmenopausal women, significantly reduces bone density and increases the risk of fractures. Cortical bone, which constitutes the largest calcium deposit in the human skeleton, is primarily affected in various conditions, including osteoporosis. Due to its visibility in panoramic radiography, the cortical area of the mandibular canal could be valuable in assessing decreases in bone mineral density (BMD). PURPOSE The study aimed to characterize and compare changes in the cortices of the mandibular canal between normal, osteopenic, and osteoporotic postmenopausal women. STUDY DESIGN, SETTING, SAMPLE Our cross-sectional study analyzed postmenopausal patients. We included only patients with panoramic radiographs with good quality and who underwent osteoporosis risk assessment by dual-energy x-ray absorptiometry (DXA). INDEPENDENT VARIABLE BMD was measured by DXA at 3 sites (spine, femur, and forearm) and used to classify the patients into normal, osteopenic, or osteoporotic. This classification remained consistent across all measurement sites. MAIN OUTCOME VARIABLE The main outcome variable was BMD of the mandibular canal cortices measured using black pixel intensity. COVARIATES Demographic covariates, including age, weight, height, and BMD, were assessed. ANALYSES One-way analysis of variance between groups considering a P < .05. The relationship between covariates and dependent variables was assessed using the Pearson correlation test. RESULTS The sample comprised 52 postmenopausal women aged more than 40 years (mean age 61 ± 10 years), 26 (50%) normal, 18 (35%) osteopenic, and 8 (15%) osteoporotic. Significant differences were observed in the percentage of black pixels in the mandibular ramus between the groups. In this region, the average percentage of black pixels was 3.19% (± 0.65) for the normal group, 2.78% (± 0.65) for the osteopenia group, and 2.35% (± 0.65) for the osteoporosis group (P = .015). No significant differences were found in other mandibular regions. CONCLUSION AND RELEVANCE Our findings demonstrate an association between BMD assessed in the mandibular canal cortex and the presence of osteoporosis as determined by DXA. While the observed differences in black pixel percentages in the mandibular ramus are minor, they are statistically significant, suggesting that panoramic radiography may serve as an adjunctive tool for osteoporosis screening.
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Affiliation(s)
- Angela Jordão Camargo
- Postdoctoral Student, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Giovani Antonio Rodrigues
- Postdoctoral Student, Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Luciana Munhoz
- Postdoctoral Student, Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alan Grupioni Lourenço
- Postdoctoral Student, Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Professor, Department of Morphology, Physiology, and Basic Pathology, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Plauto Christopher Aranha Watanabe
- Postdoctoral Student, Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Tekin G, Kocak ATO, Kuleli B, Ozturk T, Dereci O, Kose NS, Ugurlu M, Kosar YC, Caliskan G. The effect of mentoplate application on the condyle. BMC Oral Health 2024; 24:722. [PMID: 38915000 PMCID: PMC11194891 DOI: 10.1186/s12903-024-04506-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024] Open
Abstract
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.
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Affiliation(s)
- Gorkem Tekin
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey.
| | | | - Batuhan Kuleli
- Faculty of Dentistry, Department of Orthodontics, Osmangazi University, Eskisehir, Turkey
| | - Taner Ozturk
- Faculty of Dentistry, Department of Orthodontics, Kayseri, Turkey
| | - Omur Dereci
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
| | - Nesrin Saruhan Kose
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
| | - Mehmet Ugurlu
- Faculty of Dentistry, Department of Orthodontics, Osmangazi University, Eskisehir, Turkey
| | - Yasin Caglar Kosar
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
| | - Gizem Caliskan
- Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, Osmangazi University, Eskisehir, Turkey
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Serindere G, Aktuna Belgin C, Gunduz K. EVALUATION OF MANDIBULAR TRABECULAR AND CORTICAL STRUCTURE BY FRACTAL ANALYSIS IN HYPERLIPIDEMIA AND HYPERTENSION PATIENTS. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101953. [PMID: 38908478 DOI: 10.1016/j.jormas.2024.101953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 06/12/2024] [Accepted: 06/19/2024] [Indexed: 06/24/2024]
Abstract
INTRODUCTION This study aimed to evaluate the mandibular trabecular and cortical changes in patients with hyperlipidemia (HL) and/or hypertension (HT) using fractal dimension (FD) analysis, mandibular cortical width (MCW), panoramic mandibular index (PMI) and mandibular cortical index (MCI). MATERIALS AND METHODS Panoramic radiographs of 100 patients were evaluated. FD measurement of three region of interest (ROI) including the angulus, corpus and interdental bone area were made. MCW, PMI and MCI were also measured and noted. RESULTS Angulus, corpus and interdental FD values were significantly lower in three disease groups than the control group. Angulus, corpus, and interdental FD values were significantly lower in the HL+HT group than in the HL group and HT group. MCW value was significantly lower in the HL group, HT group, and HL+HT group than the control group. The cortical index C1 was more common in the control group while C2 was more common in the HT, HL and HL+HT group. CONCLUSION The fact that FD was significantly lower in the HL+HT group compared to the HL and HT groups indicates the positive effect of their association on bone loss and quality. FD measurements on images obtained using a direct digital panoramic system can be used for treatment planning and follow-up of patients with HL and/or HT.
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Affiliation(s)
| | - Ceren Aktuna Belgin
- Hatay Mustafa Kemal University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Hatay, TÜRKİYE.
| | - Kaan Gunduz
- Ondokuz Mayıs University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Samsun, TÜRKİYE.
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Song YW, Park JY, Kwon YH, Jang WE, Kim SJ, Seo JT, Moon SJ, Jung UW. Host modulation therapy for improving the osseointegration of dental implants under bone healing-suppressed conditions: a preclinical rodent-model experiment. J Periodontal Implant Sci 2024; 54:177-188. [PMID: 37857517 PMCID: PMC11227931 DOI: 10.5051/jpis.2301800090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/27/2023] [Accepted: 07/26/2023] [Indexed: 10/21/2023] Open
Abstract
PURPOSE Placing dental implants in areas with low bone density or in conditions where bone healing is suppressed is challenging for clinicians. An experiment using a rodent model was performed with the aim of determining the efficacy of host modulation by increasing the systemic level of cholesterol sulfate (CS) using Irosustat in the context of the bone healing process around dental implants. METHODS In 16 ovariectomised female Sprague-Dawley rats, 2 implant fixtures were placed in the tibial bones (1 fixture on each side). At 1 week after surgery, the high-CS group (n=8) received Irosustat-mixed feed, while the control group (n=8) was fed conventionally. Block specimens were obtained at 5 weeks post-surgery for histologic analysis and the data were evaluated statistically (P<0.05). RESULTS Unlike the high-CS group, half of the specimens in the control group demonstrated severe bone resorption along with a periosteal reaction in the cortex. The mean percentages of bone-to-implant contact (21.5%) and bone density (28.1%) near the implant surface were significantly higher in the high-CS group than in the control group (P<0.05), as was the number of Haversian canals (by 5.3). CONCLUSIONS Host modulation by increasing the CS level may enhance the osseointegration of dental implants placed under conditions of impaired bone healing.
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Affiliation(s)
- Young Woo Song
- Department of Periodontology, Gangnam Severance Hospital, Yonsei University College of Dentistry, Seoul, Korea
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
| | - Jin-Young Park
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Yoon-Hee Kwon
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea
| | - Wooyoung Eric Jang
- Department of Oral Biology, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Sung-Jin Kim
- Department of Oral Histology and Developmental Biology, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Korea
| | - Jeong Taeg Seo
- Department of Oral Biology, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Seok Jun Moon
- Department of Oral Biology, BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Ui-Won Jung
- Department of Periodontology, Research Institute for Periodontal Regeneration, Yonsei University College of Dentistry, Seoul, Korea
- Innovation Research and Support Center for Dental Science, Yonsei University Dental Hospital, Seoul, Korea.
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Kaya S, Koc A. Radiologic evaluation of associated symptoms and fractal analysis of unilateral dens invaginatus cases. Oral Radiol 2024:10.1007/s11282-024-00756-4. [PMID: 38748387 DOI: 10.1007/s11282-024-00756-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/27/2024] [Indexed: 07/07/2024]
Abstract
OBJECTIVE The aim of this study is to determine the age-based prevalence of dens invaginatus cases and to learn the radiologic findings. In addition, fractal analysis of the periapical regions of unilateral dens invaginatus cases and contralateral teeth was performed to determine the effect of possible microleakage on fractal dimension. METHODS A total of 136 patients (170 teeth) identified in panoramic radiographs taken for diagnostic purposes between January 2018 and December 2023 at our Department of Oral and Maxillofacial Radiology were included in the study. Data were analysed using IBM SPSS V23. The Chi-square test was used for comparing categorical variables between groups. The relationship between the FD values calculated around the apexes of the teeth with unilateral dens invaginatus and the contralateral teeth was analyzed by paired t test. A significance level of p < 0.050 was adopted. RESULTS The mean age of the cases was calculated as 28.1 (8-63) years. 66 (48.5%) of the cases were female, and 70 (51.1%) were male. The lateral incisor was the most affected tooth among these cases. Bilateral cases were observed in 34 patients. Type 2 was detected in 93 patients, Type 1 in 35 patients, and Type 3 dens invagination in 8 patients. Dens invaginatus cases were observed in 134 maxillary and 2 mandibular teeth. Periapical lesions were seen in 22 of these cases. CONCLUSIONS Dens invaginatus cases are a congenital anomaly encountered at any age. Early diagnosis is crucial to prevent the loss of pulp vitality due to these invaginations. It should be noted that these invaginations can affect both jaws. However, due to the prevalence of occurrence in the maxillary anterior teeth and asymptomatic nonvitality, particular attention should be paid to evaluating this region.
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Affiliation(s)
- Sema Kaya
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey.
| | - Alaettin Koc
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yuzuncu Yil University, Van, Turkey
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Anandan R, C.L K, Ganesan A, Aniyan K. Y. Strut and radio-morphometric analysis of mandibular trabecular structure in pre-and post-menopausal women to aid in the diagnosis of osteoporosis. J Oral Biol Craniofac Res 2024; 14:273-279. [PMID: 38559588 PMCID: PMC10979266 DOI: 10.1016/j.jobcr.2024.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 02/10/2024] [Accepted: 03/08/2024] [Indexed: 04/04/2024] Open
Abstract
Purpose The purpose of the study is to evaluate the mandibular trabecular pattern in pre- and postmenopausal age women. By analysing the strut, fractal, grey level co-occurrence matrix, and radio-morphometric indices in the panoramic radiograph. Method Panoramic radiographs from 2019 to 2022 were used to assess pre- and postmenopausal women's bone mineral density. A total of 272 panoramic radiographs, which exhibited clear visibility of the mental foramen on both sides without any blurring, motion artefacts, surgical errors, overlapping hyoid bone, or inferior mandibular cortex, were divided into two groups. Group A (136 premenopausal women) and Group B (136 postmenopausal women). It is a retrospective study that is non-interventional/observational in design. Strut features, fractal dimensions, a grey-level co-occurrence matrix, and radio morphometric indices were used to investigate bone texture in an image processing program. The mean difference between group variables was calculated using an independent sample t-test/unpaired t-test. Results Pre-menopausal women had a mean age of 38.83 ± 6.01 years, while postmenopausal women had a mean age of 68.26 ± 8.31 In the postmenopausal group Four regions of interest exhibited fractal dimensions with a P value of less than 0.01 and GLCM features including contrast (0.812), correlation (0.230), energy (0.215), and homogeneity (0.322). Strut features of the four regions showed that 15 of 19 characteristics were significantly different. Conclusion Orthopantomogram is useful in screening for osteoporosis. Strut, radio-morphometric indices, and fractal analysis can assess bone texture and quality. Future research incorporating artificial intelligence can revolutionize image analysis and support clinical decision-making.
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Affiliation(s)
- Ragavendiran Anandan
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
| | - Krithika C.L
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
| | - Anuradha Ganesan
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
| | - Yesoda Aniyan K.
- Department of Oral Medicine and Radiology, SRM Dental College, no.1 Bharathi Salai, Ramapuram, Chennai-600089, India
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Tercanlı H, Bolat Gümüş E. Evaluation of mandibular trabecular bone structure in growing children with Class I, II, and III malocclusions using fractal analysis: A retrospective study. Int Orthod 2024; 22:100875. [PMID: 38692119 DOI: 10.1016/j.ortho.2024.100875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 04/04/2024] [Accepted: 04/06/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE The present study aimed to evaluate the mandibular bone structure of patients with different malocclusions by using fractal dimension (FD) analysis on dental panoramic radiographic images. MATERIAL AND METHODS Pre-treatment panoramic radiographic images of 103 patients were included in the study and divided into 3 groups as Class I (group 1: 0 RESULTS FD values were lower in Class I sagittal skeletal pattern than Class II and III groups in anterior ROI FD, premolar ROI FD, angulus ROI FD, and mean FD values. There were differences between Class I and Class III skeletal patterns (P=0.023 for anterior ROI FD, P=0.016 for premolar ROI FD, P=0.034 for angulus ROI FD, and P=0.014 for mean FD). Class I and II malocclusions differed in anterior ROI FD (P=0.029) and also Classes II and III showed differences in angulus ROI FD (P=0.029). CONCLUSION Sagittal skeletal patterns may result in differences in the structure of the mandibular trabecular bone.
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Affiliation(s)
- Hümeyra Tercanlı
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, 07058 Antalya, Turkey
| | - Esra Bolat Gümüş
- Department of Orthodontics, Faculty of Dentistry, Akdeniz University, 07058 Antalya, Turkey.
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Bostan SA, Özarslantürk S, Günaçar DN, Gonca M, Göller Bulut D, Ok Bostan H. Direct-Acting Oral Anticoagulant/Vitamin K Antagonists: Do They Affect the Trabecular and Cortical Structure of the Mandible? J Clin Densitom 2024; 27:101495. [PMID: 38688206 DOI: 10.1016/j.jocd.2024.101495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND This study aimed to evaluate the mandibular bone structure of patients using oral anticoagulants (OACs) vitamin K antagonist drugs (warfarin) and other OACs including direct oral anticoagulants [(DOACs) apixaban, rivaroxaban, dabigatran, edoxaban]. Analyses were based upon the fractal dimension (FD), the panoramic mandibular index (PMI) and the Klemetti index (KI), which is also known as the mandibular cortical index (MCI). METHODOLOGY Ninety participants were divided into three groups: group 1: 30 systemically healthy individuals who had not used any anticoagulants before, group 2: 30 individuals using warfarin, and group 3: 30 individuals using DOACs. FD was used to analyze trabecular bone architecture in the condyle, angle, and two sites in the alveolar bone. PMI was used to evaluate the quantity of cortical bone and KI was used to evaluate the cortical bone quality. RESULTS There was no difference between the groups regarding FD analysis and KI; however, a difference was found between groups 1, 2, and 3 in the PMI (P≤ 0.001). The PMI in group 1 was higher than in groups 2 and 3. CONCLUSION Mandibular radiomorphometric indices can be used on panoramic radiographs to evaluate the quantity of mandibular cortical bone in patients using oral anticoagulants.
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Affiliation(s)
- Semih Alperen Bostan
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Periodontology, Rize, Turkey
| | - Savaş Özarslantürk
- University of Health Sciences, Gulhane Faculty of Dental Medicine, Department of Dentomaxillofacial Radiology, Ankara, Turkey
| | - Dilara Nil Günaçar
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Rize, Turkey
| | - Merve Gonca
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Orthodontics, Rize, Turkey
| | - Duygu Göller Bulut
- Bolu Abant İzzet Baysal University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Bolu, Turkey
| | - Hilal Ok Bostan
- Recep Tayyip Erdoğan University, Faculty of Dentistry, Department of Prosthodontics, Rize, Turkey.
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Acar G, Aktaş A. Assessment of jaw bone mineral density, resorption rates, and oral health in patients with severe hemophilia: a case-control study. Acta Odontol Scand 2024; 83:132-139. [PMID: 38597918 DOI: 10.2340/aos.v83.40337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/14/2024] [Indexed: 04/11/2024]
Abstract
OBJECTIVE Knowledge about oral hygiene, gingival bleeding, mineral density, and resorption of jaw bones in patients with hemophilia is limited. We evaluated the periodontal and bone status in such patients. Material and methods: Forty-eight patients with severe type A/B hemophilia and 49 age- and sex-matched controls were included. Assessments included simplified oral hygiene index (OHI-S), calculus index, debris index, gingival index (GI), gingival bleeding time index (GBTI), and decayed, missing, and filled teeth index (DMFTI). Bone resorption was evaluated using panoramic mandibular index (PMI), mental index (MI), and alveolar crest ratio (ACR). Mineral density in the condyle, angulus, and premolar areas was assessed using fractal analysis, with fractal dimensions denoted as condyle fractal dimension (CFD) for the condyle, angulus fractal dimension (AFD) for angulus, and premolar fractal dimension (PFD) for premolar region. RESULTS The mean scores were DMFTI = 11.77, OHI-S = 2.44, PMI = 0.268, MI = 5.822, GI = 3.02, GBTI = 2.64, ACR = 2.06, CFD = 1.31, AFD = 1.31, and PFD = 1.17 in the hemophilia group and DMFTI = 11.449, PMI = 0.494, MI = 7.43, GI = 0.67, GBTI = 0.98, OHI-S = 1.45, ACR = 2.87, CFD = 1.35, AFD = 1.35, and PDF = 1.23 in the control group. Differences were significant for all parameters (p < 0.005) except for the DMFTI index. Conclusions: Because of poor oral hygiene, high bone resorption, and low bone mineral density in these patients, clinicians should consider potential bone changes when planning to treat these patients.
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Affiliation(s)
- Gülin Acar
- Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey.
| | - Alper Aktaş
- Oral and Maxillofacial Surgery, Hacettepe University, Ankara, Turkey
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Kotan S, Koç A, Öner Talmaç AG. The current overview of the devices of temporary anchorage placed on the palatal bone: CBCT study. Odontology 2024:10.1007/s10266-024-00931-3. [PMID: 38564121 DOI: 10.1007/s10266-024-00931-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 03/21/2024] [Indexed: 04/04/2024]
Abstract
Temporary anchorage devices (TADs) are frequently applied to different anatomic areas with different protocols to increase skeletal effects and anchorage in orthodontic treatment planning. It has been reported in many literatures that primary stability for orthodontic TADs is significant for long-term survival rate. For this reason, different areas of the palatal region, which has many indications, have been widely used in the studies. In this evaluation where bone quality and thickness are important, density, bone thickness, and fractal dimension (FD) on cone beam computed tomography (CBCT) will provide more predictable clinical results. The aim of this study was to evaluate bone thickness, density, and FD in the palatal region of the first, and second premolars, and first molars. There was a remarkable difference (p < 0.05) between the parameters of FD, thickness and density of bone in the identified areas in the palatal region. In terms of thickness and FD, the 1st premolar region had significantly higher values than the other regions (p < 0.05). In terms of density, the values in the right 1st molar and right 1st premolar regions were significantly higher (p < 0.05). The 1st premolar region is an ideal site for placement of palatal TADs. CBCT-assisted preliminary evaluation of FD value, bone density, and thickness may increase clinical success when selecting the location of TADs to be applied to the palatal bone.
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Affiliation(s)
- Seda Kotan
- Department of Orthodontics, Faculty of Dentistry, Iğdır University, Iğdır, 76000, Turkey.
| | - Alaettin Koç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
| | - Ayşe Gül Öner Talmaç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Van Yüzüncü Yıl University, Van, Turkey
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12
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Surenthar M, Srinivasan SV, Parimala D, Ramanathan V. Degenerative Temporomandibular Disorders: An Assessment of Bone Trabecular Structure Using Fractal Analysis in Digital Panoramic Radiographs. Cureus 2024; 16:e57449. [PMID: 38699100 PMCID: PMC11064817 DOI: 10.7759/cureus.57449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
Introduction Fractal analysis has proved to be a salient tool to quantitatively assess the qualitative changes in the bone trabeculae of patients with hyperparathyroidism, osteoporosis, and various temporomandibular disorders, including osteoarthritis (OA) and rheumatoid arthritis of temporomandibular joint (TMJ), in several previous studies. The purpose of this study was to use fractal analysis to assess alterations in the trabecular pattern of the mandibular condyle in patients with degenerative temporomandibular disorders. Materials and methods This study comprised 98 subjects with 49 subjects in the study group and 49 subjects in the control group, aged 18-50 years. Age and sex in the control group were matched to those in the case group. The subjects were assessed clinically with the Diagnostic Criteria for Temporomandibular Disorders. Digital panoramic X-ray equipment with set parameters of 70 kvp, 8 mA, and 16-second exposure duration was used to take panoramic radiographs. Fractal analysis was done and the calculated fractal dimension value was obtained using ImageJ version 1.48 software (National Institutes of Health, Bethesda, MD). The same observer used Muir and Goss's method to rate the total degenerative changes in the condylar surfaces, which were substantiated by the calculated fractal dimension value. The data were statistically analyzed. Results The results revealed a significant difference (p-value = 0.041) between the mean fractal value in the case group's (1.35) and the control group's (1.38) left sides whereas the differences in the mean fractal values between the case and control groups on the right side was not significant (p-value = 0.49). Conclusion It is recommended to use the fractal dimension value and the total degenerative severity score together to quantify degenerative changes in the TMJ OA rather than exclusively relying on fractal value.
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Affiliation(s)
| | - Subramanian V Srinivasan
- Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, IND
| | - Djeapragassam Parimala
- Oral Medicine and Radiology, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Puducherry, IND
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13
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Munhoz EA, Xavier CRG, Salles RP, Capelozza ALA, Bodanezi AV. Convenient model of hard tissue simulation for dental radiographic research and instruction. World J Methodol 2024; 14:88850. [PMID: 38577207 PMCID: PMC10989409 DOI: 10.5662/wjm.v14.i1.88850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 12/20/2023] [Accepted: 01/19/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND The authors describe a technique for building an alternative jawbone phantom using dental gypsum and rice for research and dental radiology instruction. AIM To investigate the potential of an alternative phantom to simulate the trabecular bone aspect of the human maxilla in periapical radiographs. METHODS Half-maxillary phantoms built from gypsum-ground rice were exposed to X-rays, and the resulting images (experimental group) were compared to standardized radiographic images produced from dry human maxillary bone (control group) (n = 7). The images were blindly assessed according to strict criteria by three examiners for the usual trabecular aspects of the surrounding bone, and significant differences between groups and in assessment reliability were compared using Fisher's exact and kappa tests (α = 0.05). RESULTS The differences in the trabecular aspects between groups were not statistically significant. In addition, interobserver agreement among observers was 0.43 and 0.51 for the control and experimental groups, respectively, whereas intraobserver agreement was 0.71 and 0.73, respectively. CONCLUSION The tested phantom seemed to demonstrate potential for trabecular bone image simulation on maxillary periapical radiographs.
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Affiliation(s)
- Etiene Andrade Munhoz
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
| | - Claudio Roberto Gaiao Xavier
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Roberto Ponce Salles
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Ana Lúcia Alvares Capelozza
- Department of Stomatology, Radiology and Oral Surgery, School of Dentistry, University of São Paulo, Bauru 17012-901, Brazil
| | - Augusto Vanni Bodanezi
- Department of Dentistry, Health Science Centre, Federal University of Santa Catarina, Florianopolis 88040-379, Brazil
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Akbulut S, Bayrak S. Evaluation´ of mandibular alveolar bone in patients with different vertical facial patterns : A cross-sectional CBCT study. J Orofac Orthop 2024; 85:89-97. [PMID: 35788398 DOI: 10.1007/s00056-022-00408-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 05/23/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE The study aimed to investigate the morphological and structural differences of mandibular alveolar bone between different vertical facial patterns (VFP). METHODS In all, 66 CBCT scans of patients were selected for the study: 24 were designated as hyperdivergent, 25 as normodivergent, and 17 as hypodivergent. Fractal values of the interdental alveolus were measured at the incisor, canine, premolar, and molar regions. The minimum trabecular bone width (MTBW) of the alveolus, the buccal and lingual cortical bone thicknesses, and the total alveolar width (AW) at the minimum trabecular bone level were measured. One-way analysis of variance and Tukey test were used to compare the groups. The correlations between FMA (Frankfurt mandibular plane angle) and other measurements were analyzed by Pearson analysis. RESULTS No significant differences were detected in fractal values and buccal and lingual cortical bone thicknesses between the groups. The MTBW and AW of the hypodivergent individuals were found to be higher in the anterior and premolar interdental sites. FMA was found to be significantly correlated with MTBW and AW. CONCLUSIONS The patients with different VFPs did not exhibit significant differences in the trabecular complexity of the mandibular alveolus. Hypodivergent patients tend to have thicker trabecular and alveolar bone widths than normodivergent and hyperdivergent individuals.
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Affiliation(s)
- Sibel Akbulut
- Faculty of Dentistry, Department of Orthodontics, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Seval Bayrak
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Bolu Abant Izzet Baysal University, Bolu, Turkey.
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15
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Temur KT, Magat G, Cosgunarslan A, Ozcan S. Evaluation of Jaw Bone Change in Children and Adolescents with Rheumatic Heart Disease by Fractal Analysis. Niger J Clin Pract 2024; 27:260-267. [PMID: 38409156 DOI: 10.4103/njcp.njcp_346_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 12/26/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND Recognizing the oral needs of people living with rheumatic heart disease (RHD), particularly in relation to their jaws, is of paramount importance. AIMS This study aimed to evaluate potential jaw bone changes in children and adolescents diagnosed with RHD and compare them with a group of healthy children and adolescents. METHODS AND MATERIAL The dental panoramic radiographs (DPRs) of 32 children and adolescents diagnosed with RHD comprised the case group. In contrast, the control group consisted of DPRs from 32 children and adolescents without any known diseases. Two regions of interest (ROI1 and ROI2) of trabecular bone and a separate region of interest (ROI3) of cortical bone were selected for fractal analysis. The mandibular cortical index (MCI) was evaluated. RESULTS The ROI1 fractal dimension (FD) value of the individuals in the case group was statistically higher in the right jaw than in the left jaw (P < 0.01). Significant differences were determined between the case and control groups regarding the left ROI1, and the left and the right ROI2 (P < 0.05). No significant difference was found between the patient and control groups regarding the MCI value (P > 0.05). CONCLUSIONS The results of this study showed that bone metabolism was affected unilaterally in the condyle region and bilaterally in the gonial region of patients with RHD. It also revealed that the cortical layer was not affected.
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Affiliation(s)
- K T Temur
- Oral and Maxillofacial Radiology, Niğde Ömer Halisdemir University, Niğde, Turkey
| | - G Magat
- Oral and Maxillofacial Radiology, Necmettin Erbakan University, Konya, Turkey
| | - A Cosgunarslan
- Oral and Maxillofacial Radiology, Erciyes University, Kayseri, Turkey
| | - S Ozcan
- Oral and Maxillofacial Radiology, İzmir Katip Çelebi University, İzmir, Turkey
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16
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Polat Balkan E, Paksoy CS, Bağış N. Fractal analysis of the effects on mandibular bone of botulinum toxin therapy of the masseter muscle in patients with bruxism. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 137:83-88. [PMID: 37805341 DOI: 10.1016/j.oooo.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/03/2023] [Accepted: 08/09/2023] [Indexed: 10/09/2023]
Abstract
OBJECTIVE We examined changes in the mandibular angle, ramus, and condylar neck of patients with bruxism after botulinum toxin-A (BTX-A) injection into the masseter muscle as calculated with fractal analysis (FA) on panoramic radiographs (PRs). METHODS We examined the PRs of 3 groups of 22 patients each (n = 66) obtained upon presentation and 6 months later. One group included healthy controls without bruxism, one group included patients with untreated bruxism, and one group included patients with bruxism who had undergone BTX-A injection into the masseter muscle. We performed FA of the bilateral angle, ramus, and condylar neck of the PRs to calculate fractal dimension (FD). RESULTS The FD values of the angle on the second PRs of the untreated bruxism group were significantly higher than those of the other groups (P = .026), specifically when compared to the BTX-A injection group (P = .017). The FD values in the angle and ramus of the bruxism group were significantly higher on the second PRs (P ≤..005)) Conversely, the FD values in the angle of the BTX-A injection group were significantly lower on the second PR (P = .039). CONCLUSIONS Masseter muscle hyperactivity due to bruxism increases bone density in masseter muscle attachment regions. BTX-A injection restricts muscle activity, thereby chnging bone structure and decreasing FD.
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Affiliation(s)
- Elif Polat Balkan
- Ankara University, Faculty of Dentistry, Department of DentoMaxillofacial Radiology, Ankara, Turkey.
| | - Candan S Paksoy
- Ankara University, Faculty of Dentistry, Department of DentoMaxillofacial Radiology, Ankara, Turkey
| | - Nilsun Bağış
- Ankara University, Faculty of Dentistry, Department of Periodontology, Ankara, Turkey
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17
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Çoban Büyükbayraktar Z, Eninanç İ. Assessment of mandibular trabecular structure and cervical vertebral maturation using fractal analysis. Technol Health Care 2024; 32:1211-1221. [PMID: 38043029 DOI: 10.3233/thc-231100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Changes in bone trabeculae occur during skeletal maturation. Fractal analysis is a technique for assessing changes in the internal structure of the bone. OBJECTIVE The aim of this study was to investigate correlation of bone trabeculation measured on panoramic and lateral cephalometric radiographs with cervical vertebral maturation stages (CVMS). METHODS CVMS was evaluated on lateral cephalometric radiographs of 120 individuals aged 6 to 18 years. The subjects were divided into 6 groups (n= 20 each) according to CVMS. On panoramic and lateral cephalometric radiographs, fractal dimension (FD) analyses were performed in mandibular corpus, gonial and condylar regions and cervical vertebral bodies (C2, C3, C4). RESULTS FD measurements from the mandibular corpus region bilaterally and C2-C4 vertebral bodies showed significant positive correlations with CVMS (r= 0.418, r= 0.412, r= 0.324, r= 0.304, r= 0.263, respectively). Significant differences were found in the FD values of the right/left mandibular corpus and C2 and C3 vertebrae compared to CVMS (P< 0.001, P< 0.001, P= 0.005, P= 0.019, respectively). CONCLUSION Significant positive moderate correlations between the FD values of the right and left mandibular corpus and CVMS suggest that fractal analysis may be useful in determining skeletal maturity stage. The significant FD values obtained from the right/left mandibular corpus, and C2 and C3 vertebra indicate that the complexity of the internal trabecular structure increases with maturation.
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Affiliation(s)
| | - İlknur Eninanç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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18
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Ozturk EMA, Artas A. Evaluation of Bone Mineral Changes in Panoramic Radiographs of Hypothyroid and Hyperthyroid Patients Using Fractal Dimension Analysis. J Clin Densitom 2024; 27:101443. [PMID: 38070428 DOI: 10.1016/j.jocd.2023.101443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 11/13/2023] [Indexed: 02/16/2024]
Abstract
Objective Hyperthyroidism and hypothyroidism are endocrinopathies that cause a decrease in bone mineral density. The aim of this study is to investigate possible bone changes in the mandible caused by hyperthyroidism and hypothyroidism using fractal analysis (FA) on panoramic radiographs. Material and Methods Panoramic radiographs of a total of 180 patients, including 120 patient groups (60 hyperthyroid, 60 hypothyroid) and 60 healthy control groups, were used. Five regions of interests (ROI) were determined from panoramic radiographs and FA was performed. ROI1: geometric midpoint of mandibular notch and mandibular foramen, ROI2: geometric midpoint of mandibular angle, ROI3: anterior of mental foramen, ROI4: basal cortical area from distal mental foramen to distal root of first molar, ROI5: geometric center of mandibular foramen and mandibular ramus. Results While a significant difference was observed between the patient and control groups regarding ROI1 and ROI2 (p < 0.05); there was no significant difference between the groups in relation to ROI3, ROI4, and ROI5. All FA values were lower in the hyperthyroid group than in the hypothyroid group. Conclusion Fractal analysis proves to be an effective method for early detection of bone mass changes. In the present study, it was concluded that while the mandibular cortical bone was intact, trabecular rich regions were affected by osteoporosis caused by thyroid hormones. Necessary precautions should be taken against the risk of osteoporosis in patients with thyroid hormone disorders.
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Affiliation(s)
- Elif Meltem Aslan Ozturk
- DDS, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara Medipol University, Cankaya, Ankara, Turkey.
| | - Aslihan Artas
- DDS, Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Sütcü Imam University, 46050 Onikisubat, Kahramanmaras, Turkey
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19
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Dedeoğlu N, Eşer G, Çelik Özen D, Altun O. Five-year change of panoramic radiomorphometric indices and fractal dimension values in type 2 diabetes patients. Oral Radiol 2024; 40:49-57. [PMID: 37610653 DOI: 10.1007/s11282-023-00707-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
OBJECTIVES Diabetes mellitus is a chronic disease characterized by dysregulation of glucose metabolism, with characteristic long-term complications accompanied by changes in bone quality. The purpose of this study is to compare the results with a control group by performing radiomorphometric analyses on panoramic radiographs obtained 5 years apart to examine changes in the mandibular bone cortex and microstructures of type 2 diabetes mellitus (T2DM) patients. METHODS Two panoramic radiographs that were taken 5 years (mean 5.26 ± 0.134) apart from 52 patients with T2DM (n:26) and a control group (n:26) were used. A total of 104 images were evaluated. Analyses were done from the condyle (FD1), angulus (FD2), distal second premolar apex (FD3), and anterior to the mental foramen (FD4) for fractal dimension (FD) in the mandible. Symphysis index (SI), anterior index (AI), molar index (MI), posterior index (PI), and panoramic mandibular index (PMI) measurements were taken for cortical analysis. Three-way ANOVA, three-way robust ANOVA, two-way ANOVA, and two-way robust ANOVA tests were used for statistical analysis (p < 0.05). RESULTS After a 5-year period, there was a significant decrease in all FD measures of the mandible in both T2DM and control groups (p < 0.05). This resulted in a statistical difference in the main effect of time. After a 5-year period, no significant difference in mandibular cortical measures was identified between the T2DM and control groups (p > 0.05). CONCLUSION According to panoramic radiography, the mandibular trabecular structure deteriorated after 5 years, whereas cortical values remained the same. It concluded that T2DM had no effect on these results.
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Affiliation(s)
- Numan Dedeoğlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey.
| | - Gözde Eşer
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Duygu Çelik Özen
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
| | - Oğuzhan Altun
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Inonu University, 44280, Malatya, Turkey
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Altunok M, Miloğlu Ö, Doğan H, Yılmaz AB, Uyanık A, Çankaya E. Fractal characteristics of the trabecular pattern of the mandible in patients with renal transplantation. Clin Transplant 2024; 38:e15236. [PMID: 38289886 DOI: 10.1111/ctr.15236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/10/2023] [Accepted: 12/26/2023] [Indexed: 02/01/2024]
Abstract
OBJECTIVE In this study, we examined the mandibular trabecular bone structures by performing fractal dimension (FD) analysis in patients who underwent renal transplantation (RTx). METHODS Our study is an observational study with 69 RTx patients and 35 control group patients. The mean FD values of the patient and control groups were calculated and compared. In addition, biochemical parathyroid hormone (PTH), serum calcium, phosphorus, alkaline phosphatase (ALP), and vitamin-D parameters and FD values of both groups were analyzed. RESULTS FD values were significantly lower in the patient group than in the healthy group (p < .05). In the RTx group compared to the control group, ALP (90.71 ± 34.25-66.54 ± 16.8, respectively) (p < .001) and PTH (75.76 ± 38.01-38.17 ± 12.39, respectively) (p < .001) values were higher. There was a positive correlation between the FD values and ALP (rspearman = .305, p = .011) and a negative correlation between FD values and vitamin-D (rspearman = .287, p = .017) of patients with RTx. CONCLUSION FD values were found to be lower in patients who underwent RTx compared to the control group. It should be considered that FD analysis can be a method that can be used to evaluate trabecular bone structure in patients undergoing RTx.
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Affiliation(s)
- Murat Altunok
- Department of Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Özkan Miloğlu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Hasan Doğan
- Department of Medical Biology Genetics, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Ahmet Berhan Yılmaz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey
| | - Abdullah Uyanık
- Department of Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Erdem Çankaya
- Department of Nephrology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
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Wen C, Zhang Q. Pilot study of fractal dimension analysis of osteogenesis for bone substitute materials of Bio-Oss in lateral sinus augmentation. PLoS One 2023; 18:e0296248. [PMID: 38157335 PMCID: PMC10756558 DOI: 10.1371/journal.pone.0296248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 12/09/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Fractal dimension (FD) analysis has been proposed and validated in osseointegration-related research. The aim of this study was to evaluate the feasibility of FD analysis in the osteogenesis detection of bone substitute materials (BSMs) of Bio-Oss in maxillary lateral sinus augmentation. METHODS Patients who received lateral maxillary sinus augmentation and underwent grafting with BSMs (Bio-Oss) were included in the study. The cross sections of the BSMs under cone-beam computed tomography (CBCT) at mesial, distal, and sagittal directions were obtained immediately after the graft (T0) and 6 months later (T1), and the obtained images were cropped to include only the BSMs. The FD analysis was performed, and the FD value was obtained by the method of box-counting. Paired t-tests and analysis of variance (ANOVA) were used, and p-values <0.05 was considered statistically significant. RESULTS Twelve participants with 22 implants, which were inserted simultaneously after sinus augmentation, were included in this study. A total of 22 mesial, 22 distal, and 14 sagittal images were obtained after FD analysis. The mean FD value and standard deviation at T0 was 1.2860 ± 0.0896, while at T1, it was 1.2508±0.1023; thus, significant differences were detected (p = 0.022). However, the increasing or decreasing trend of FD value was not stable, and no significant difference was detected for FD values of mesial, distal, and sagittal images between T0 and T1. ANOVA indicated that no significant difference was detected among the FD values of mesial, distal, and sagittal images at any timepoint. Differences in FD values between the sexes were not significant either. CONCLUSIONS Since the FD analysis for the osteogenesis detection of BSMs in maxillary sinus augmentation indicated unstable trends of change, its feasibility is not reliable. The initially rough surface, self-degradation, and volume change of the BSMs during osteogenesis may be the reason for the variation in FD values.
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Affiliation(s)
- Cai Wen
- Department of Oral Implantology, The Affiliated Stomatology Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Department of VIP Dental Service, The Affiliated Stomatology Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, The Affiliated Stomatology Hospital, Southwest Medical University, Luzhou, Sichuan, China
- Institute of Stomatology, Southwest Medical University, Luzhou, Sichuan, China
| | - Qing Zhang
- Department of Nosocomial Infection Control, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China
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Akkaya S, Toptaş O. Evaluation of the effects of platelet-rich fibrin and diode laser on gingival blood perfusion and early bone healing of the extraction socket: a randomized controlled clinical trial. Lasers Med Sci 2023; 39:2. [PMID: 38082098 DOI: 10.1007/s10103-023-03947-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/05/2023] [Indexed: 12/18/2023]
Abstract
Evaluation and comparison of the effect of platelet-rich fibrin (PRF), diode laser, and combination of PRF and diode laser on gingival blood perfusion and early bone formation of the extraction socket. Forty maxillary premolar sockets were randomized to four groups: control group, PRF group, diode laser group, and PRF + diode laser group. Gingival blood perfusion was measured at preoperative and postoperative 1, 3, 7, and 30 days. Fractal dimension analysis was performed immediately after the procedure and in the postoperative first month. Gingival perfusions significantly increased during 1 week compared to baseline for all groups with a mean of -4.43 ± 3.20, -5.99 ± 3.68, -5.45 ± 3.01, and -4.78 ± 2.82 respectively, and were at baseline 1 month later. There were no statistically significant differences between the groups at any time point. Although the increase of fractal dimension was higher in the PRF or diode laser group than in the control group with a mean of 0.085 ± 0.05, 0.100 ± 0.04, and 0.072 ± 0.04 respectively, no statistically significant differences were detected. Fractal dimension was significantly greater in PRF + diode laser group than in the control group with a mean of 0.138 ± 0.05 (p = 0.04). PRF, diode laser, and PRF + diode laser did not significantly affect the gingival perfusion, and the combined application of PRF and diode laser had positive effects on early bone regeneration in the extraction socket. PRF, diode laser, and PRF + diode laser provide better tissue healing of the extraction socket.
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Affiliation(s)
- Selda Akkaya
- Department of Oral and Maxillofacial Surgery, Private Practice, Istanbul, Turkey.
| | - Orçun Toptaş
- Department of Oral and Maxillofacial Surgery, Private Practice, Istanbul, Turkey
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Gulec M, Tassoker M, Erturk M. Evaluation of cortical and trabecular bone structure of the mandible in patients using L-Thyroxine. BMC Oral Health 2023; 23:886. [PMID: 37986156 PMCID: PMC10659045 DOI: 10.1186/s12903-023-03670-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 11/14/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Long-term use of L-Thyroxine (LT4), the synthetic thyroxine hormone used for thyroid hormone replacement therapy, is an important risk factor for osteoporosis. The aim of this study was to investigate the differences between mandibular cortical index (MCI) and trabecular bone fractal dimension (FD) values on panoramic radiographs of patients using LT4 and control subjects. METHODS A total of 142 female patients, 71 cases and 71 controls, were analyzed in the study. Ages were matched in case and control groups and the mean age was 36.6 ± 8.2 (18 to 50) years. MCI consisting of C1 (Normal Mandibular Cortex), C2 (Moderately Resorbed Mandibular Cortex) and, C3 (Severely Resorbed Cortex) scores was determined for case and control groups. Fractal analysis was performed using ImageJ on selected regions of interest from the gonial and interdental regions. The box-count method was used to calculate FD values. Wilcoxon signed-rank test, Mann-Whitney U test, and Spearman correlation analysis were applied to compare the measurements. Statistical significance of differences was established at P < 0.05 level. RESULTS FD values did not show statistically significant differences between case and control groups (p > 0.05). The mean FD in the right gonial region was 1.38 ± 0.07 in the case group and 1.38 ± 0.08 in the control group (p = 0.715). The mean FD in the right interdental region was 1.37 ± 0.06 in the cases and 1.36 ± 0.06 in the control group (p = 0.373). The mean FD in the left gonial region was 1.39 ± 0.07 in the cases and 1.39 ± 0.07 in the control group (p = 0.865). The mean FD in the left interdental region is 1.37 ± 0.06 in the cases and 1.38 ± 0.05 in the control group (p = 0.369). The most common MCI score was C1, with 62% in the cases and 83.1% in the control group. MCI scores showed a statistically significant difference between cases and controls (p = 0.016, p < 0.05). While the C2 score was higher in the cases, the C1 score was higher in the controls. CONCLUSIONS LT4 use was not associated with the FD of mandibular trabecular bone, but was associated with MCI values of cortical bone. Further studies on larger samples with different imaging modalities and image processing methods are needed.
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Affiliation(s)
- Melike Gulec
- Department of Dentomaxillofacial Radiology, Karamanoğlu Mehmetbey University Faculty of Dentistry, Karaman, Turkey
| | - Melek Tassoker
- Department of Dentomaxillofacial Radiology, Necmettin Erbakan University Faculty of Dentistry, Bağlarbaşı sk, Meram, Konya, 42050, Turkey.
| | - Mediha Erturk
- Department of Dentomaxillofacial Radiology, Necmettin Erbakan University Faculty of Dentistry, Bağlarbaşı sk, Meram, Konya, 42050, Turkey
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Gulec M, Erturk M, Tassoker M, Basdemirci M. Evaluation of cortical and trabecular bone structure of the mandible in patients with ankylosing spondylitis. Sci Rep 2023; 13:19762. [PMID: 37957329 PMCID: PMC10643636 DOI: 10.1038/s41598-023-47233-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023] Open
Abstract
This study aimed to examine the difference between the fractal dimension (FD) values of the mandibular trabecular bone and the panoramic mandibular index (PMI), mandibular cortical index (MCI) and mandibular cortical thickness (MCW) of patients with ankylosing spondylitis (AS) and healthy control group. A total of 184 individuals (92 cases, 92 controls), were examined in our study. PMI, MCI, and MCW values were calculated on panoramic images of all individuals. For FD values, the region of interest (ROI) was selected with the size of 100 × 100 pixels from the right-left gonial and interdental regions and 50 × 50 pixels from the condylar region. Degenerative changes in the temporomandibular joint (TMJ) region were recorded. PMI, MCI, and MCW values showed statistically significant differences between the groups (p = 0.000, p < 0.001). The radiological signs of mandibular cortical resorption were more severe in the case group than in the control group. PMI and MCW values were found to be lower in the case group than in the control group. It was determined that the number of C3 and C2 values, among the MCI values, was higher in the case group. Only the FD values of the ROI selected from the condyle region were found to be statistically significant and were lower in the case group (p = 0.026, p < 0.05). Degenerative changes in the TMJ region were significantly more frequent in the case groups (p = 0.000, p < 0.001). The fact that the mandibular cortex shows more resorptive features in individuals with AS may require further evaluation in terms of osteoporosis. Because of the low FD values of the condylar regions of these patients and the more frequent degenerative changes, the TMJ region should be followed carefully. Detailed examination of the mandibular cortex and condylar region is beneficial in patients with AS for screening and following osteoporotic changes in these individuals, which is essential for the patient's life quality.
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Affiliation(s)
- Melike Gulec
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Karamanoğlu Mehmetbey University, Karaman, Turkey
| | - Mediha Erturk
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Melek Tassoker
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey.
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Czajkowska S, Rupa-Matysek J, Nijakowski K, Gil L, Surdacka A, Kulczyk T. A Panoramic X-ray as a Supportive Diagnostic Tool for the Screening of Osteoporosis in Patients with Hemophilia A and B. J Clin Med 2023; 12:6901. [PMID: 37959366 PMCID: PMC10647299 DOI: 10.3390/jcm12216901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/10/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Hemophilia is associated with an increased risk of developing osteoporosis and osteopenia. The aim of the study was to interpret the usefulness of fractal analysis of the trabecular bone of the mandible (FD) and selected radiomorphic indices (the antegonial index (AI) and Klemetti index (KI)) to assess the risk of reduced bone mineral density (BMD) in patients with hemophilia A/B. METHODS The study group consisted of 50 patients with type A/B hemophilia. The control group consisted of 25 males without congenital bleeding disorders. The patients had a panoramic radiograph taken with the same X-ray machine (Vistapano S, Durr Dental, Bietigheim-Bissingen, Germany). The AudaXCeph software (Audax d.o.o., Ljubljana, Slovenia) was used to evaluate the AI index, and the ImageJ, software with a specially prepared script, was used to evaluate the FD. The mandibular cortex was assessed distal to the mental foramen using the Klemetti index. RESULTS There were no statistically significant differences between the AI, KI and FD values between the study group and the control group. CONCLUSIONS This study indicated the lack of usefulness of AI, KI and fractal analysis in identifying patients with hemophilia at risk of reduced bone mass.
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Affiliation(s)
- Sylwia Czajkowska
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland (A.S.)
| | - Joanna Rupa-Matysek
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Kacper Nijakowski
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland (A.S.)
| | - Lidia Gil
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, 60-812 Poznan, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, 60-812 Poznan, Poland (A.S.)
| | - Tomasz Kulczyk
- Department of Diagnostics, Poznan University of Medical Sciences, 60-812 Poznan, Poland
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Ersan N, Özel B. Evaluation of mandibular cortical and trabecular radiomorphometry in familial Mediterranean fever patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:640-648. [PMID: 37422403 DOI: 10.1016/j.oooo.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/12/2023] [Accepted: 05/29/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE The objective of this retrospective study was to evaluate the mandibular cortical and trabecular morphology and microarchitecture of patients with familial Mediterranean fever (FMF) and compare them to those of healthy individuals by examining radiomorphometric indices on panoramic radiographs. STUDY DESIGN We examined a group of 56 FMF patients aged 5 to 71 years and an age- and sex-matched control group of individuals with no systemic diseases. We classified the FMF and control groups according to age and sex and the FMF group according to colchicine use. We evaluated the quantitative radiomorphometic indices of gonial index, antegonial index, molar cortical thickness, mental index, panoramic mandibular index, and lacunarity, and the qualitative mandibular cortical index on all panoramic radiographs and performed between and within group analysis. RESULTS Mean gonial index, antegonial index, and molar cortical thickness values of the FMF group were significantly smaller than those of the control group. Significantly fewer patients in the FMF group were classified as mandibular cortical index type 1 compared to the control group. There were no significant differences in quantitative index values according to colchicine use in the FMF group or regarding the categorical parameters of age, sex, and mandibular cortical index classification. CONCLUSIONS Radiomorphometric values of the mandibular basal cortex posterior to the mental foramen differ significantly in FMF patients compared to healthy counterparts. Dentists should note mandibular morphologic changes indicative of low bone density when examining panoramic images of patients with this disease.
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Affiliation(s)
- Nilüfer Ersan
- Department of Dentomaxillofacial Radiology, Yeditepe University Faculty of Dentistry, Istanbul, Turkey.
| | - Beliz Özel
- Department of Endodontics, Academic Centre for Dentistry Amsterdam, Amsterdam, Netherlands
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de Oliveira Loures A, de Abreu M, Devito KL, Grisolia-Seifert EF, Jähn-Rickert K, Rabelo GD. Fractal analysis of the mandible cortical bone: correlation among fractal dimension values obtained by two processing methods from periapical radiograph and micro-computed tomography with cone-beam computed tomography. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2023; 62:511-518. [PMID: 37792108 DOI: 10.1007/s00411-023-01045-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 09/23/2023] [Indexed: 10/05/2023]
Abstract
The objectives of the present study were to assess Fractal Dimension (FD) values in the mandible cortical bone obtained from digital periapical radiographs (DPR), high-resolution microtomography (µCT), and cone-beam computed tomography (CBCT), by two processing methods: binarization (FD.b) and grayscale-based method (FD.f) and, finally, to identify the correlation among these values with other micro-architectural parameters. For this, a prospective study was conducted on 18 healthy individuals (mean age 23 ± 2.4 years old) who underwent third molar extraction. Pre-operative CBCT scans were conducted, bone fragments were removed from the retro-molar region, and DPR and µCT were performed on those bone samples. FD.b and FD.f values were calculated using three parasagittal sections for CBCT, one image for DPR, and three sections for µCT. The 3D bone microarchitecture was analyzed in µCT (voxel size: 19 µm). As a result, FD.b mean values of 1.55 ± 0.02 and 1.80 ± 0.01 were obtained for CBCT and µCT, respectively. Furthermore, FD.f mean values of 1.22 ± 0.12 for DPR, 0.99 ± 0.04 for CBCT, and 1.30 ± 0.07 for µCT were obtained. Both FD.b and FD.f values showed a good agreement. FD.f was negatively correlated with the standard deviation of the mean gray value (p = 0.003) for DPR and intra-cortical bone surface (p = 0.02) for µCT. In conclusion, image processing with or without binarization revealed different values for FD, although showing agreement. The grayscale-based method retrieved FD values correlated with the gray levels and the cortical porous network, which means that FD can be a valuable index for mandibular cortical bone evaluation. FD is associated with mineralization and microarchitecture. Nevertheless, there was no correlation between FD values obtained from low- (DPR) and high-resolution (µCT) X-ray modalities with FD obtained from the in vivo CBCT.
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Affiliation(s)
| | - Matheus de Abreu
- Department of Dentistry, Universidade Federal de Santa Catarina, Rua Delfino Conti, 1240-Bairro Trindade, Florianópolis, SC, 88040-900, Brazil
| | - Karina Lopes Devito
- School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Eric Flavio Grisolia-Seifert
- Department of Osteology and Biomechanics, Bioengineering and Medical Technology Heisenberg Research Group, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Jähn-Rickert
- Department of Osteology and Biomechanics, Bioengineering and Medical Technology Heisenberg Research Group, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Mildred Scheel Cancer Career Center Hamburg, University Cancer Center Hamburg, Martinistr. 52, 20251, Hamburg, Germany
| | - Gustavo Davi Rabelo
- School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
- Department of Dentistry, Universidade Federal de Santa Catarina, Rua Delfino Conti, 1240-Bairro Trindade, Florianópolis, SC, 88040-900, Brazil.
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Alpaydin MT, Buyuk SK, Abay F, Korkmaz YN. Evaluation of mandibular osseous structure in patients with mandibular asymmetry: a fractal analysis study. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:656-662. [PMID: 37516622 DOI: 10.1016/j.oooo.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 06/02/2023] [Accepted: 06/17/2023] [Indexed: 07/31/2023]
Abstract
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.
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Affiliation(s)
- Mehmed Taha Alpaydin
- Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkiye.
| | | | - Feridun Abay
- Department of Orthodontics, Faculty of Dentistry, Ordu University, Ordu, Turkiye
| | - Yasemin Nur Korkmaz
- Department of Orthodontics, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Bolu, Turkiye
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Eninanç İ, Büyükbayraktar ZÇ. Assessment of correlation between hand-wrist maturation and cervical vertebral maturation: a fractal analysis study. BMC Oral Health 2023; 23:798. [PMID: 37884998 PMCID: PMC10601178 DOI: 10.1186/s12903-023-03483-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 10/03/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND To investigate whether fractal dimension (FD) measurements from hand-wrist radiographs and lateral cephalometric radiographs are correlated with each other and with skeletal maturation stages. METHODS In this retrospective study conducted on hand-wrist and lateral cephalometric radiographs obtained from patients between 2017 and 2023, hand-wrist maturation stages (HWMS) and cervical vertebral maturation stages (CVMS) of 144 subjects (6 to 17 years of age) were assessed radiographically. The participants were divided into nine groups (n = 16 each) based on HWMS. Fractal analysis was performed on the radiographs of the radius, the middle finger phalanges (proximal, medial and distal), and the cervical vertebral bodies (C2, C3, C4). Mean and standard deviation values, Spearman's and Pearson correlation analyses, one-way ANOVA, Kruskal-Wallis H tests and Mann-Whitney-U test were used to evaluate the data. RESULTS Positive correlations were found between the FD values of the radius and HWMS or CVMS (r = .559, P = .001, r = .528 P = .001 respectively). The FD values of the radius were positively correlated with those of all cervical vertebrae (C2, C3, C4), proximal and medial phalanges as well as age. FD values measured from the proximal phalanx, medial phalanx and radius showed significant differences among both HWMS and CVMS (P < .05). HWMS was strongly correlated with CVMS (r = .929, P = .001). Age was strongly correlated with HWMS (r = .795, P = .001) and CVMS (r = .756, P = .001). There was a significant difference in terms of age distribution among HWMS and CVMS (P < .05). CONCLUSIONS FD measurements on hand-wrist radiographs can provide useful information for the assessment of skeletal maturation stage. Especially, FD measurements from the radius are important and more reliable to predict skeletal maturation stage.
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Affiliation(s)
- İlknur Eninanç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey.
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Afzoon S, Ghorbani F, Hasani M. Evaluation of the mandibular condyles trabecular structure in patients with severe class III pattern: a computed tomography (CT) fractal analysis study. Sci Rep 2023; 13:18183. [PMID: 37875543 PMCID: PMC10598208 DOI: 10.1038/s41598-023-45407-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/19/2023] [Indexed: 10/26/2023] Open
Abstract
Class III malocclusion is a combination of dental and skeletal disorders that causes discrepancies in occlusion. Malocclusion can affect the structure of the Temporomandibular joint (TMJ) resulting in many problems, one of which is affecting the internal structure of the bone. This study aimed to examine the morphological features of class III patients' trabecular structure of the mandibular condyle in comparison with normal class I individuals using fractal analysis (FA). To study the internal structure of the mandibular condyle bone, Computed Tomography (CT) scans of 45 severe class III patients (age: 16-46) who were the candidates for orthognathic surgery were selected and matched by age and sex with 45 normal class I individuals. The trabecular bone structure of the left and right mandibular condyles in three CT planes of the study group and control group were evaluated employing the FA. The result of the present study indicated that the fractal dimensions (FD) values of class III patients were lower than those of the normal class I individuals in axial (class I: 1.31 ± 0.02, class III: 1.28 ± 0.02), sagittal (class I: 1.25 ± 0.03, class III: 1.19 ± 0.08), and coronal (class I: 1.5 ± 0.06, class III: 1.45 ± 0.07) planes (P < 0.001). There were no significant differences between the FD values of the males and females. The intra-group evaluation revealed that there was no correlation between age and FD values. No evidence of laterality was found regarding the FD values of the right and left condyles. Given the noticeable differences between the FD values, it can be implied that severe class III malocclusion may affect the trabecular pattern of the cancellous bone of the mandibular condyle compared to class I individuals. Therefore, due to the altered trabecular structure, clinicians should be cautious when planning treatments for these patients.
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Affiliation(s)
- Saeed Afzoon
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farhad Ghorbani
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahvash Hasani
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran.
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Bolat Gümüş E, Yavuz E, Tufekci C. Effects of functional orthopedic treatment on mandibular trabecular bone in class II patients using fractal analysis. J Orofac Orthop 2023; 84:155-164. [PMID: 35501504 DOI: 10.1007/s00056-022-00397-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/06/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE The aim of this retrospective study was to evaluate the effects of functional orthopedic treatment on mandibular bone structure using fractal dimension (FD) analysis of panoramic radiographs. METHODS The study material consisted of the pre- and posttreatment digital panoramic radiographs of 80 patients (mean age 10.1 ± 2.01 years; 45 girls, 35 boys) with class II malocclusion who were treated with the monoblock or twin block appliances. The following regions of interest (ROI) were selected: ROI1, condylar process; ROI2, angulus mandibulae; ROI3, corpus mandibulae; and ROI4, mental foramen. Pre- and posttreatment FD values were compared for each ROI. RESULTS FD values of the mandibular condyle did not change with the functional orthodontic treatment. FD values of the mandibular corpus region had the highest pretreatment values and significantly decreased with treatment (p < 0.05). CONCLUSION Functional orthopedic treatment altered the trabeculation of the mandibular bone, but it is speculated that the changes in the occlusal forces seemed to be of primary significance for this effect.
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Affiliation(s)
- Esra Bolat Gümüş
- Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
| | - Esra Yavuz
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
| | - Cansu Tufekci
- Department of Orthodontics, Faculty of Dentistry, Akdeniz University, Antalya, Turkey
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Park WB, Lim HC. Management of Posterior Mandibular Bone Cavitation for Dental Implant Placement: A Case Series of 5-24 Years of Follow-Up. J ORAL IMPLANTOL 2023; 49:517-523. [PMID: 37776246 DOI: 10.1563/aaid-joi-d-22-00211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2023]
Abstract
Focal osteo-cavitation in the posterior mandible is a condition that clinicians do not know well. Inadvertent implant placement in such areas may result in nerve damage due to abrupt drill penetration and implant displacement in the medullary space. In the present case series, focal osteo-cavitation was managed with the following procedures: (1) undersized drilling, (2) gentle trabecular curettage, (3) bone substitute material grafting in the cavity, and (4) long healing period for osseointegration. In all cases, a sudden loss of drilling pressure immediately after passing through the thin cortical layer revealed focal osteo-cavitation. Following undersized drilling and gentle trabecular curettage, the bone substitute material was packed into the cavity with care not to press the inferior alveolar canal. Implant placement was subsequently performed. Despite a lack of primary implant stability in 3 of 4 cases, all implants were successfully osseointegrated after 6-9 months. Over 5-24 years, all implants functioned well.
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Affiliation(s)
- Won-Bae Park
- Private Practice in Periodontics and Implant Dentistry, Seoul, Korea
| | - Hyun-Chang Lim
- Department of Periodontology, Periodontal-Implant Clinical Research Institute, Kyung Hee University College of Dentistry, Kyung Hee University Medical Center, Seoul, Korea
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Arrepia BF, Rocha TG, Medeiros AS, Ferreira MD, Fonseca-Gonçalves A, Visconti MA. The mandibular bone structure in children by fractal dimension and its correlation with pixel intensity values: a pilot study. Oral Radiol 2023; 39:771-778. [PMID: 37368081 DOI: 10.1007/s11282-023-00693-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES To identify a normal pattern of mandibular trabecular bone in children based on the fractal dimension (FD), and its possible correlation with pixel intensity (PI) values, to facilitate the early diagnosis of possible diseases and/or future bone alterations. MATERIALS AND METHODS The 50 panoramic images were selected and divided into two groups, according to the children's age: 8-9 (Group 1; n = 25) and 6-7 (Group 2; n = 25). For FD and PI analyses, three regions of interest (ROIs) were selected, and their mean values were evaluated for each ROI, according to each group, using the t test for independent samples and the model of generalized estimation equations (GEE). Subsequently, these mean values were correlated by the Pearson test. RESULTS Comparing the groups, FD and PI did not differ from each other for any of the measured regions (p > 0.00). It was observed that in the mandible branch (ROI1), FD and PI means were 1.26 ± 0.01 and 81.0 ± 2.50, respectively. In the mandible angle (ROI2), the means were 1.21 ± 0.02 (FD) and 72.8 ± 2.13 (PI); and in the mandible, cortical (ROI3) values of FD = 1.03 ± 0.01 and PI = 91.3 ± 1.75 were obtained. There was no correlation between FD and PI in any of the analyzed ROI (r < 0.285). The FD means of ROI1 and ROI2 did not differ from each other (p = 0.053), but both were different from ROI3 (p < 0.00). All PI values differed from each other (p < 0.00). CONCLUSION The bone trabeculate pattern in 6-9-year-old children presented FD between 1.01 and 1.29. Besides that, there was no significant correlation between FD and PI.
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Affiliation(s)
- Beatriz Fernandes Arrepia
- Department of Pediatric Dentistry and Orthodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thaiza Gonçalves Rocha
- Department of Pathology and Oral Diagnosis, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Annie Seabra Medeiros
- Department of Pathology and Oral Diagnosis, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Matheus Diniz Ferreira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Andrea Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Mishra S, Kumar M, Mishra L, Panda S, Panda S, Lewkowicz N, Lapinska B. Estimation of Cancellous Changes Using Fractal Analysis in Patients with Periodontitis. Biomedicines 2023; 11:2547. [PMID: 37760988 PMCID: PMC10525952 DOI: 10.3390/biomedicines11092547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Periodontal disease is a broad term given when the periodontium is affected by inflammation. There are several methods to diagnose periodontitis, but no method to quantify the cancellous bone is presently used. For this purpose, a non-invasive tool that is efficient in analyzing bone quality called fractal analysis can be employed. The objective of the study was to utilize fractal dimension (FD) to evaluate cancellous patterns of interproximal alveolar bone using a digital intraoral periapical radiograph (IOPAR) in different clinical presentations of periodontitis classified according to the latest classification by the World Workshop for Periodontal and Peri-Implant Diseases and Conditions, 2017 (WWDC, 2017). The study aimed to numerically calculate the periodontitis changes in the cancellous bone around the affected tooth on an IOPAR using fractal analysis and to provide an additional criterion for the staging of periodontitis. In this cross-sectional observational study, 75 patients were selected and equally allotted to five groups based on the staging system proposed by the WWDC, 2017. The region of interest was selected on the IOPA radiograph of the tooth with the site having the most significant clinical attachment loss, and FD was calculated using Image J analysis. The association of gender and age with stages of periodontitis was studied using the chi-square test of independence. A comparison of % bone loss and fractal dimension among stages was studied by using the non-parametric Kruskal Wallis test. The relationship between % bone loss and fractal dimension within stages and gender was studied by using the Karl Pearson correlation. A receiver operating characteristic (ROC) curve analysis was performed for FD value as a marker of periodontitis patients. We demonstrated that the FD values decreased significantly with the increase in stages (p < 0.0001). The overall relationship between % bone loss and FD showed a significantly strong negative correlation of -0.739 (p < 0.0001), except for stages III and IV. FD can be utilized as a quantitative method for detecting cancellous bone changes in different stages of periodontitis, aiding in diagnosing periodontitis.
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Affiliation(s)
- Sukanya Mishra
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India; (S.M.); (S.P.)
| | - Manoj Kumar
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India; (S.M.); (S.P.)
| | - Lora Mishra
- Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India;
| | - Swagatika Panda
- Department of Oral Pathology and Microbiology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India;
| | - Saurav Panda
- Department of Periodontics and Oral Implantology, Institute of Dental Sciences and SUM Hospital, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India; (S.M.); (S.P.)
| | - Natalia Lewkowicz
- Department of Periodontology and Oral Diseases, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland;
| | - Barbara Lapinska
- Department of General Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland
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Kurşun BÜ, Akan E. Evaluation of trabecular bone changes according to the type of prosthesis in patients using bisphosphonates: a retrospective study. Braz Oral Res 2023; 37:e089. [PMID: 37672422 DOI: 10.1590/1807-3107bor-2023.vol37.0089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Accepted: 11/14/2022] [Indexed: 09/08/2023] Open
Abstract
The objective of the study was to retrospectively compare the fractal size values calculated in the trabecular bone according to the type of complete removable denture, removable partial denture, and partial fixed prosthesis between patients using bisphosphonates and healthy patients, retrospectively. Panoramic radiographs of a total of 200 patients, (100 using bisphosphonates,100 control group), were taken from the right and left molar regions before and after treatment with 72 × 72 pixels. The fractal dimension (FD) was computed by using ImageJ Software using the box-counting method on the images obtained. There was an interaction effect between the trabecular bone change-patient group-the type of prosthesis used and the parameters of the area (p < 0.05). In patients using complete removable dentures and removable partial dentures in the maxilla and mandibula in the molar region, a greater decrease in FD values was observed in the control group than in the patient group using bisphosphonates. An increase in FD values over time was observed in the patient group using bisphosphonates with partial fixed maxillary and mandibular prostheses compared to the control group. Partial fixed prostheses should be preferred primarily instead of complete removable or removable partial dentures in patients using bisphosphonates to prevent osteonecrosis due to dental trauma.
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Affiliation(s)
- Begüm Ünlü Kurşun
- Izmir Tinaztepe University, Department of Prosthetic Dentistry, Izmir, Turkey
| | - Ender Akan
- University of Katip Çelebi, Department of Prosthetic Dentistry, Izmir, Turkey
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Musulluoğlu F, Alan H, Yılmaz S. Investigation of the effect of oral and internal bisphosphonate use on bone density in the jaws in patients with osteoporosis in panoramic radiography. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:284-293. [PMID: 37316421 DOI: 10.1016/j.oooo.2023.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 02/02/2023] [Accepted: 02/17/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVES This study aims to quantitatively evaluate the effects of bisphosphonate use duration and route of administration on mandibular cortical and trabecular bone in postmenopausal women. STUDY DESIGN Ninety postmenopausal women over the age of 50 were included in this study. Trabecular bone density was specified numerically by fractal dimension (FD) in the region of interest selected on the panoramic radiograph. The width of the mandibular cortical (MCW) bone under the mental foramen of the mandible was measured. Mann-Whitney U test was used for parameters that did not show a normal distribution. Spearman rho correlation test was used to determine the relationship between continuous measurement parameters. RESULTS It was observed that FD and MCW of dentate and edentate individuals using bisphosphonate were statistically significantly lower than those of healthy individuals (P < .05). There was no significant correlation was found between the duration of use of bisphosphonates and the fractal values obtained from the relevant regions of the mandible (P > .05). CONCLUSION Fractal dimension was found to be lower in oral bisphosphonate use than in intravenous bisphosphonate use. The width of the mandibular cortical bone values was found to be lower in individuals using bisphosphonate than in healthy individuals. Fractal dimension and MCW may benefit clinicians as quantitative parameters in panoramic radiography in the diagnosis of osteoporosis.
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Affiliation(s)
- Ferhat Musulluoğlu
- Department of Oral and Maxillofacial Surgery, Inonu University Faculty of Dentistry, Malatya, Turkey.
| | - Hilal Alan
- Department of Oral and Maxillofacial Surgery, Inonu University Faculty of Dentistry, Malatya, Turkey
| | - Serkan Yılmaz
- Department of Dentomaxillofacial Radiology, Ministry of Health, Mersin Oral and Dental Health Hospital, Mersin, Turkey
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Ornek Akdogan E, Omezli MM, Torul D. Comparative evaluation of the trabecular structure of the mandibular condyle, the levels of salivary cortisol, MMP-3, TNF-α, IL-1β in individuals with and without temporomandibular joint disorder. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101417. [PMID: 36739977 DOI: 10.1016/j.jormas.2023.101417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 02/02/2023] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Temporomandibular disorder (TMD) is still a challenge in terms of diagnosis and management. The aim of this study is to explore if the evaluation of salivary biomarkers and fractal dimension (FD) of mandibular condyle could be useful for interpreting early degenerative changes and the effectiveness of salivary cortisol in determining the stress levels of TMD patients. MATERIALS AND METHODS 34 patients with TMD, and 34 healthy controls were included in this study. Saliva samples were obtained from all participants between 09:00-12:00 am. Salivary cortisol, IL-1β, TNF-α, and MMP-3 levels were evaluated with ELISA method. FD of the mandibular condyle was determined by means of box-counting method. Depression and anxiety were determined with PHQ-9 and GAD-7 questionnaires. RESULTS The salivary cortisol and depression/anxiety were higher in study group; however, not significant (p>0.05). FD of the study group was found significantly lower than the control group (p<0.01). Salivary TNF-α, IL-1β and MMP-3 levels were showed no significant difference between the two groups (p>0.05). There were no significant correlations between the evaluated parameters. CONCLUSION Salivary cortisol seems to be a non-invasive way of measuring physiological stress of TMD patients. Fractal analysis may be a useful tool in detecting early structural changes in mandibular condyle. Salivary TNF-α. IL-1β and MMP-3 have not a diagnostic value in terms of interpreting early degenerative changes.
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Affiliation(s)
- Emine Ornek Akdogan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Karabük University, Karabük, TURKEY.
| | - Mehmet Melih Omezli
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, TURKEY
| | - Damla Torul
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ordu University, Ordu, TURKEY
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Pereira DA, Mendes PGJ, Prisinoto NR, de Rezende Barbosa GL, Soares PBF, de Oliveira GJPL. Advanced platelet-rich-fibrin (A-PRF +) has no additional effect on the healing of post-extraction sockets of upper third molars. A split mouth randomized clinical trial. Oral Maxillofac Surg 2023; 27:411-419. [PMID: 35614276 DOI: 10.1007/s10006-022-01075-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/13/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE This study evaluated the effects of advanced platelet-rich fibrin (A-PRF +) on the healing of upper third molar post-extraction sockets. METHODS Sixteen patients who underwent extractions of the upper third molars (18 and 28) were included in this randomized split-mouth study. The alveoli on the test side were filled with A-PRF + , while the control side was maintained with blood clot. The side that received treatment was randomly defined. Alveolar bone regeneration was evaluated by CBCT scans to assess healing stage, bone density, and fractal analysis 1 week and 90 days post-extraction. Additionally, pain, edema, bleeding, and soft tissue alveolar repair were evaluated by clinical analyses 3, 7, 14, 30, and 90 days after the surgical procedure using a visual analog scale. RESULTS There were no clinical differences regarding treatments in any experimental period. In the tomographic evaluation, at 7 days, the alveoli treated with A-PRF + presented a suggestive sign of higher bone density than the control alveoli, which was not confirmed 90 days after the surgical procedure. CONCLUSION Thus, the use of A-PRF + does not demonstrate a clinical advantage in the repair of post-extraction sockets of upper third molars.
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Affiliation(s)
- Davisson Alves Pereira
- Department of Periodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlândia, MG, Brazil
| | - Pedro Gomes Junqueira Mendes
- Department of Periodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlândia, MG, Brazil
| | - Nuryê Rezende Prisinoto
- Department of Periodontology, School of Dentistry, Federal University of Uberlandia - UFU, Uberlândia, MG, Brazil
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Çolak S, Altan A, Bayrak S, Akbulut N. Evaluation of bony changes observed in mandibular osteotomy lines and mandibular condyles following bilateral sagittal ramus osteotomy by fractal analysis. Oral Maxillofac Surg 2023; 27:519-526. [PMID: 35831722 DOI: 10.1007/s10006-022-01101-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 07/10/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to evaluate the surgically impacted trabecular changes in mandibular osteotomy lines and mandibular condyles after bilateral sagittal split ramus osteotomy using the fractal analysis method. MATERIALS AND METHOD The study population consisted of 30 patients (9 male, 21 female) diagnosed with mandibular prognathism and operated with bilateral sagittal split ramus osteotomy under general anesthesia. Fractal analyses observed the alterations on the trabecular structure of osteotomy lines, and mandibular condyles on panoramic radiographs obtained preoperatively, postoperatively, 1st week, 6th month, and 12th month. The box-counting method was used to evaluate the changes in trabecular structure by fractal analysis. P-values of less than 0.05 were considered significant. RESULTS The fractal dimension values in both osteotomy lines and mandibular condyles were significantly decreased on postoperative 1st week regarding preoperative values. However, fractal dimension values commenced increasing in the following postoperative period. The fractal dimension values of the horizontal and vertical osteotomy lines reached their preoperative values on postoperative 6th and 12th month, respectively. The decreased fractal dimension values observed in the early postoperative period in the right and left condyles reached their preoperative values at the 6th postoperative month. CONCLUSION Fractal analyses performed postoperatively can provide information about trabecular changes and bone healing of structures such as osteotomy lines directly affected by bilateral sagittal split ramus osteotomy and indirectly affected mandibular condyles. The results support that fractal analysis can be used together with clinical data in the evaluation of bone healing process.
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Affiliation(s)
- Sefa Çolak
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpasa University, Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi Dis Hekimligi Fakültesi, Merkez, Tokat, 60030, Turkey.
| | - Ahmet Altan
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Konya Necmettin Erbakan University, Beysehir Caddesi, Baglarbası Sk, Meram, Konya, 42090, Turkey
| | - Seval Bayrak
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Bolu Abant Izzet Baysal University, Abant Izzet Baysal Universitesi Dis Hekimligi Fakultesi, Golkoy Kampusu, Bolu, Turkey
| | - Nihat Akbulut
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tokat Gaziosmanpasa University, Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi Dis Hekimligi Fakültesi, Merkez, Tokat, 60030, Turkey
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Çitir M, Karslioglu H, Uzun C. Evaluation of mandibular trabecular and cortical bone by fractal analysis and radiomorphometric indices in bruxist and non-bruxist patients. BMC Oral Health 2023; 23:522. [PMID: 37491268 PMCID: PMC10369695 DOI: 10.1186/s12903-023-03245-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/20/2023] [Indexed: 07/27/2023] Open
Abstract
BACKGROUND The aim of this study was to evaluate the effect of bruxism on the cortical and trabecular bone of the mandible using the radiomorphometric indexes and fractal analysis (FA) additionally to examine the efficiency of FA as diagnostic test for bruxism. METHODS Evaluation was performed on panoramic radiographs of 94 bruxists and 94 non-bruxist individuals with the ImageJ program. Cortical bone was assessed with mandibular cortical index, mental index, and panoramic mental index. Trabecular bone in the condyle, gonial, and corpus region was evaluated by FA. An independent sample t and Mann-Whitney-U tests and Pearson and Spearman rank correlations were conducted for statistical analysis. RESULTS A total of 188 participants, 112 female, and 76 male, were included in the study. The sample age ranged from 18 to 43, with a mean of 27.55 (± 7.022) years. FA values of the angulus were significantly higher than those of the condyle and corpus, and the mean of the sample for the angulus, condyle, and corpus, respectively, were; 1.36 (± 10), 1.10 (± 0.9), 1.13 (± 0.8). There was a positive correlation between FA of the mandibular corpus and age (r = .163, p = .025). Females' values were smaller than males' in the FAs of three regions, and significant differences were found in FA of the condyle and angulus of the mandible, MCI, and PMI according to gender. There was no statistically significant difference between bruxist and non-bruxist patients in term of FAs of three regions, MCI, MI, and PMI values (p > .05). CONCLUSIONS FA of the condyle and angulus of the mandible, MCI, and PMI are significantly affected by gender. However bruxism doesn't cause a significant change in the fractal dimensions of the bone in the mandible and doesn't change substantially MCI, MI, and PMI.
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Affiliation(s)
- Mesude Çitir
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Tokat Gaziosmanpasa University, Tokat, Turkey.
| | - Hazal Karslioglu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Baskent, Ankara, Turkey
| | - Canan Uzun
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Health Sciences, İstanbul, Turkey
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Unal Erzurumlu Z, Sadik E, Gokkurt BN, Ozbey F, Erzurumlu K, Kasko Arici Y. Morphological evaluation of gonial and antegonial regions in bruxers on panoramic radiographic images. BMC Oral Health 2023; 23:457. [PMID: 37420199 PMCID: PMC10327333 DOI: 10.1186/s12903-023-03162-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/22/2023] [Indexed: 07/09/2023] Open
Abstract
BACKGROUND This is the first study to report both cortical and trabecular bone evaluation of mandibles in bruxers, within the knowledge of the authors. The purpose of this study was to evaluate the effects of bruxism on both the cortical and the trabecular bone in antegonial and gonial regions of the mandible, which is the attachment of the masticatory muscles, by using panoramic radiographic images. METHODS In this study, the data of 65 bruxer (31 female, 34 male) and 71 non-bruxer (37 female, 34 male) young adult patients (20-30 years) were evaluated. Antegonial Notch Depth (AND), Antegonial-Index (AI), Gonial-Index, Fractal Dimension (FD) and Bone Peaks (BP) were evaluated on panoramic radiographic images. The effects of the bruxism, gender and side factors were investigated according to these findings. The statistical significance level was set atP ≤ 0.05. RESULTS The mean AND of bruxers (2.03 ± 0.91) was significantly higher than non-bruxers (1.57 ± 0.71; P < 0.001). The mean AND of males was significantly higher than females on both sides (P < 0.05). The mean AI of bruxers (2.95 ± 0.50) was significantly higher than non-bruxers (2.77 ± 0.43; P = 0.019). The mean FD on each side was significantly lower in bruxers than in non-bruxers (P < 0.05). The mean FD of males (1.39 ± 0.06) was significantly higher than females (1.37 ± 0.06; P = 0.049). BP were observed in 72.5% of bruxers and 27.5% of non-bruxers. The probability of existing BP, in bruxers was approximately 3.4 times higher than in non-bruxers (P = 0.003), in males was approximately 5.5 times higher than in females (P < 0.001). CONCLUSION According to the findings of this study, the morphological differences seen in cortical and trabecular bone in the antegonial and gonial regions of the mandible in bruxers can be emphasized as deeper AND, higher AI, increased of existing BPs, and lower FD, respectively. The appearance of these morphological changes on radiographs may be useful for indication and follow-up of bruxism. Gender is an effective factor on AND, existing BP and FD.
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Affiliation(s)
- Zerrin Unal Erzurumlu
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Elif Sadik
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Busra Nur Gokkurt
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey
| | - Furkan Ozbey
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ordu University, Ordu, 52200, Turkey.
| | - Kerem Erzurumlu
- Computer Science and Engineer, Department of Computer Programming, Vocational School of Technical Sciences, Ordu University, Ordu, Turkey
| | - Yeliz Kasko Arici
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ordu University, Ordu, Turkey
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Prado HV, Debossan SAT, Loayza KS, Abreu LG, Brasileiro CB, Borges-Oliveira AC. Radiomorphometric indices and fractal dimension of the mandible in individuals with osteogenesis imperfecta: a matched cross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:102-111. [PMID: 36966060 DOI: 10.1016/j.oooo.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 01/25/2023] [Accepted: 02/04/2023] [Indexed: 02/14/2023]
Abstract
OBJECTIVE The objective was to analyze radiomorphometric indices (RMIs) of mandibular cortical bone and fractal dimension (FD) of trabecular bone of individuals with osteogenesis imperfecta (OI) and compare the findings to those of individuals without OI. METHODS Digital panoramic radiographs of 20 individuals with OI (case group) and 40 individuals without OI (control group) were examined. The RMIs of mandibular cortical index (MCI) and mandibular cortical thickness (MCT) were analyzed. FD of mandibular trabecular bone was calculated bilaterally in 3 regions. The chi-squared test and paired t test were used to compare the significance of differences between the groups. The effect size and minimal clinically important difference (MCID) were also determined. Significance was established at P < .05. RESULTS Categories C2 and C3 of the MCI were more frequent in individuals with OI (P < .001). The Mean MCT was 2.08 ± 0.79 in the OI case group and 2.91 ± 0.60 in the control group (P < .001). Mean FD in the condylar region was significantly lower in the OI case group (P = .002). The effect size for these 2 measures was large, and the difference between groups was greater than the MCID. CONCLUSION Radiographs of individuals with OI exhibited more porosity and diminished thickness of the mandibular cortical bone and lower FD values in the condylar trabecular bone.
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Affiliation(s)
- Heloisa Vieira Prado
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Suélen Alves Teixeira Debossan
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Katherine Silvana Loayza
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas Guimarães Abreu
- Department of Pediatric Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia Borges Brasileiro
- Department of Oral Pathology and Surgery, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ana Cristina Borges-Oliveira
- Department of Community and Preventive Dentistry, Faculty of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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Ersan N, Özel B. Fractal dimension analysis of different mandibular regions in familial Mediterranean fever patients: A cross-sectional retrospective study. PLoS One 2023; 18:e0288170. [PMID: 37390096 PMCID: PMC10313079 DOI: 10.1371/journal.pone.0288170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023] Open
Abstract
Familial Mediterranean fever (FMF) is a genetic condition that may cause loss of bone mineral density (BMD) due to chronic inflammation. Previously, fractal dimension (FD) analysis values of mandibular cortical bone were shown to be lower in osteoporosis. Therefore, FD might be considered as an auxiliary tool to refer patients for dual-energy x-ray absorptiometry (DXA), which is the gold standard for BMD measurement. The purpose of this cross-sectional retrospective study was to evaluate trabecular and cortical microarchitecture of the mandible with FD analysis on panoramic radiographs in a subpopulation of FMF. Also, the effect of colchicine use was investigated. Forty-three FMF patients, aged between 10.8 and 71.2 years, and age- and gender-matched control group consisting of patients, who had no systemic diseases, were included. Demographic information such as age and gender, and colchicine use were recorded. In terms of age, the patients were classified as <30 and 30< years. On each panoramic radiographs five regions of interest were selected on the mandible as: 1- premolar, 2- molar, 3- angular, 4- condylar, and 5- basal cortical bone regions on right (R) and left (L) sides. Statistical significance was accepted at p<0.05 level. Intra- and inter-observer agreements demonstrated good to excellent consistency. In FMF patients, L3 and L4 values were higher, whereas L5 values were lower (p<0.05) than the control group. In terms of age, the difference between groups was insignificant in FMF patients (p>0.05), whereas in control group R3 and L4 values were higher in the 30< age group (p<0.05). Regarding gender and colchicine use, the difference between groups was insignificant (p>0.05). FMF disease might be a candidate for referral to DXA examination based on decreased bone density in the mandibular cortex detected by FD measurements on routine panoramic radiographs. Further studies are warranted to ascertain this relationship.
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Affiliation(s)
- Nilüfer Ersan
- Yeditepe University Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Istanbul, Turkiye
| | - Beliz Özel
- Yeditepe University Faculty of Dentistry, Department of Endodontics, Istanbul, Turkiye
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Evaluation of bone changes on dental panoramic radiography using mandibular indexes and fractal dimension analysis in children with familial Mediterranean fever. Oral Radiol 2023; 39:312-320. [PMID: 35854189 DOI: 10.1007/s11282-022-00639-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/03/2022] [Indexed: 10/17/2022]
Abstract
AIM It was aimed to evaluate the bone microarchitecture of children with FMF in the city of Tokat, where the disease is highly prevalent, in Turkey, one of the countries where familial Mediterranean Fever (FMF) disease is the most common, using mandibular indexes and fractal dimension analysis on panoramic radiography. METHODS In this retrospective study, the results were evaluated and compared using the mandibular cortical index (MCI), the mental index (MI), the panoramic mandibular index (PMI), and the fractal dimension analysis of six different regions (condyle, angulus, and interdental) on dental panoramic radiographs in 124 children with FMF and 124 healthy children. The data were analyzed using the IBM SPSS V23. RESULTS The distribution of MCI in children with FMF was similar to the control group (p > 0.05). The mean MI (3.59) values in FMF patients were statistically higher than the control group (p = 0.016). No statistically significant difference was found in PMI between the patients with FMF and the control group (p > 0.05). No statistically significant difference was found between the mean fractal dimension (FD) values according to the groups (p > 0.05). CONCLUSION Trabecular bone microarchitecture of children with FMF is similar to healthy children. There is no correlation between the duration of colchicine use and bone microarchitecture.
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Çoban G, Öztürk T, Bilge S, Canger EM, Demirbaş AE. Evaluation of trabecular changes following advancement genioplasty combined with or without bilateral sagittal split osteotomy by fractal analysis: a retrospective cohort study. BMC Oral Health 2023; 23:160. [PMID: 36934234 PMCID: PMC10024858 DOI: 10.1186/s12903-023-02860-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/06/2023] [Indexed: 03/20/2023] Open
Abstract
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.
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Affiliation(s)
- Gökhan Çoban
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Taner Öztürk
- Department of Orthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye.
| | - Süheyb Bilge
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Emin Murat Canger
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
| | - Ahmet Emin Demirbaş
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Erciyes University, Kayseri, Türkiye
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Evaluation of Change in Radiographic Fractal Dimension around Dental Implants Placed with Low-Speed Drilling and Standard Drilling Protocols. J Clin Med 2023; 12:jcm12062244. [PMID: 36983245 PMCID: PMC10058604 DOI: 10.3390/jcm12062244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/10/2023] [Accepted: 03/10/2023] [Indexed: 03/18/2023] Open
Abstract
Osseointegration is a process that depends on a multitude of factors, including the type of drilling, whether biological or conventional. Objective: Establish box-counting dimension values for radiological images in patients with implants placed with both drilling methods. Material and method: The sample included 129 implants corresponding to 50 patients. A double-blind study of data collection was carried out with the subsequent analysis of the fractal dimension as a comparative value of the state of the trabecular architecture. Results: We found no significant differences (p ≥ 0.05) between the two study groups comparing both drilling techniques. The values for the conventional drilling technique are 0.24 ± 0.07 and for biological drilling: 0.19 ± 0.11 with a p-value of 0.767. Conclusions: The drilling technique does not influence the success of the procedure and the osseointegration process.
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Bone Regeneration Effect of Nanochitosan with or without Temporally-controlled Release of Dexamethasone. J Endod 2023; 49:496-503. [PMID: 36898664 DOI: 10.1016/j.joen.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/18/2023] [Accepted: 03/02/2023] [Indexed: 03/12/2023]
Abstract
INTRODUCTION Chitosan is a cationic biopolymer and its modification as a nanoparticle, as well as loading a corticosteroid on it, may enhance its bone regenerative effect. The aim of this study was to investigate the bone regenerative effect of nanochitosan with or without dexamethasone. METHODS Under general anesthesia, four cavities were created in the calvarium of 18 rabbits and filled with either nanochitosan, nanochitosan with a temporally-controlled release of dexamethasone (nanochitosan+dexamethasone), an autograft, or left unfilled (control). The defects were then covered with a collagen membrane. The rabbits were randomly divided into 2 groups and were sacrificed at 6 or 12 weeks post-surgery. The new bone type, osteogenesis pattern, foreign body reaction, as well as the type and severity of the inflammatory response were evaluated histologically. The amount of new bone was determined using histomorphometry and cone-beam computed tomography (CBCT). A one-way ANOVA with repeated-measures was performed to compare results between the groups at each interval. A T-test and Chi-square were also conducted to analyze changes in variables between the two intervals. RESULTS Nanochitosan and the combination of nanochitosan and dexamethasone significantly increased the combination of woven and lamellar bone (P=0.007). No sample showed a foreign body reaction or any acute or severe inflammation. Chronic inflammation was significantly decreased in number (P=0.002) and severity (P=0.003) over time. There was no significant difference between the extent and pattern of osteogenesis amongst the four groups, as evaluated by histomorphometry and CBCT at each interval. CONCLUSION Nanochitosan and nanochitosan+dexamethasone were comparable to the gold standard of autograft regarding the type and severity of inflammation, as well as the level and pattern of osteogenesis, yet they induced more woven and lamellar bone.
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Korkmaz MZ, Altin A, Günaçar DN, Köse TE. Comparison of trabecular bone structure in individuals with healthy periodontium and stage III/IV, grade C periodontitis by fractal analysis. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:427-432. [PMID: 36328893 DOI: 10.1016/j.oooo.2022.09.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 09/20/2022] [Accepted: 09/25/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aim was to perform fractal analysis (FA) to compare differences in trabecular microarchitecture in interdental and antegonial regions on panoramic radiographs in periodontally healthy patients and those with stage III/IV, grade C periodontitis, and to compare the effects of patient age and sex on FA results. STUDY DESIGN Clinical and radiographic records from 33 periodontally healthy individuals and 28 individuals with aggressive periodontitis were obtained from the faculty archives. Three regions of interest (ROIs) were chosen bilaterally from interdental bone around the mandibular first molar and canine and the antegonial region. The mean fractal dimension (FD) values of the ROIs were calculated. Significance of differences was established at P < .05. RESULTS FD values of all 3 ROIs in the periodontitis group were significantly lower than values in the control group (P ≤ .004). FD was not affected by patient age (P = .357) or sex (P = .216). There were no significant correlations between FD and age in either group (P ≥ .093). FD values differed significantly between sexes in only one ROI. CONCLUSIONS FA can effectively detect trabecular microarchitectural differences in patients with aggressive periodontitis compared to periodontally healthy individuals. This technique might be useful in predicting the susceptibility of patients to periodontal disease.
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Affiliation(s)
- Meltem Zihni Korkmaz
- Recep Tayyip Erdogan University, Faculty of Dentistry, Department of Periodontology, Rize, Turkey.
| | - Ahmet Altin
- İstanbul Kent University, Faculty of Dentistry, Department of Periodontology, İstanbul, Turkey
| | - Dilara Nil Günaçar
- Recep Tayyip Erdogan University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Rize, Turkey
| | - Taha Emre Köse
- Recep Tayyip Erdogan University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Rize, Turkey
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Kurt MH, Yilmaz S, Evli C, Karahan S. Comparative evaluation of trabecular bone structures of bruxist and non-bruxist individuals with bone apposition in the mandible angle region by fractal analysis. J Oral Rehabil 2023; 50:360-369. [PMID: 36794633 DOI: 10.1111/joor.13435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 12/01/2022] [Accepted: 02/06/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE This study aimed to compare the trabecular internal structure of different regions of the mandible according to the grades of appositional classification in the mandible angle region in probable bruxist individuals and non-bruxist G0(Convex course of the basal cortex, no directional change, no bone apposition) individuals by measuring fractal dimension (FD) on panoramic radiographs. METHODS 200 sample jaws, bilaterally, of 80 probable bruxists and 20 non-bruxist G0 individuals were included in the study. According to the classification in the literature, each mandible angle apposition severity was classified as G0-G1-G2-G3. FD was calculated by selecting the region of interest (ROI) area of 7 regions from each sample. Gender differences in changes between ROIs in radiographs and independent samples t-test were evaluated. Relation between categorical variables was determined by chi-square test (p < .05). RESULTS In the comparison of the probable bruxist and non-bruxist G0 groups, FD was found to be statistically significantly higher in the mandible angle (p = 0.013) and cortical bone (p = 0.000) regions in the probable bruxist group than in the non-bruxist G0 group. There is a statistically significant difference between probable bruxist G0 and non-bruxist G0 grades in terms of FD averages in cortical bone (p < 0.001). A statistically significant difference was found in the relationship of ROIs with gender in canine apex (p = 0.021) and canine distal (p = 0.041) regions. CONCLUSION FD was found to be higher in the mandibular angle region and cortical bone in probable bruxist individuals than in non-bruxist G0 individuals. Morphological changes seen in the mandible angulus region may be a finding that may raise suspicion for bruxism for clinicians.
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Affiliation(s)
- Mehmet Hakan Kurt
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey
| | - Serkan Yilmaz
- Faculty of Dentistry Department of Dentomaxillofacial Radiology, Erciyes University, Kayseri, Turkey
| | - Cengiz Evli
- Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara University, Ankara, Turkey
| | - Sevilay Karahan
- Faculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Turkey
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Evaluation of the effect of antiepileptic drugs on mandibular bone quality by fractal analysis. Oral Radiol 2023:10.1007/s11282-023-00671-0. [PMID: 36786955 DOI: 10.1007/s11282-023-00671-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/21/2023] [Indexed: 02/15/2023]
Abstract
OBJECTIVES Antiepileptic drugs (AEDs) are used to control seizures in epilepsy and their long-term use is common. AED use has been associated with decreased bone mineral density. The aim of this study is to determine the effect of AEDs on mandibular bone quality using fractal analysis and panoramic morphometric indices. METHODS In this study, dental and medical records of 132 patients (66 AED users and 66 control group) were used. Fractal analysis (FA), the panoramic mandibular index (PMI), mandibular cortical width (MCW), and Klemetti index (KI) measurements were performed on panoramic radiographs. RESULTS In all metrics, the mean values of the study group were significantly lower than the control group (p < 0.000). There is a statistically significant difference between the study and control groups in terms of KI distribution (p < 0.000). The mean fractal dimension (FD) values in each measured region of the female patients in the study group were found to be significantly lower than the female patients in the control group (p < 0.05). The mean FD values measured in ROI-2 and ROI-3 of male patients in the study group were found to be significantly lower than male patients in the control group (p < 0.05). CONCLUSION The side effects of AEDs on bone metabolism were shown in this study. Dentists examining patients with epilepsy should be careful about osteoporotic changes in the jaws.
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