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Khaddour AS, Popescu SM, Ionescu M, Sălan AI, Ghiţă RE, Cojocaru MO, Marinescu IR, Amărăscu MO, Draghici EC. Post-Extraction Bone Changes in Molars Within Personalized Implant-Prosthetic Therapy as Evaluated with Fractal Analysis of CBCT. J Pers Med 2025; 15:154. [PMID: 40278333 PMCID: PMC12029053 DOI: 10.3390/jpm15040154] [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: 02/19/2025] [Revised: 03/13/2025] [Accepted: 04/09/2025] [Indexed: 04/26/2025] Open
Abstract
Background: Implant-prosthetic therapy requires a detailed assessment of the bone structure before designing a personalized treatment plan. Tooth extraction at the molar level is followed by a series of bone changes dependent on the patient's general condition and age and the area in which it was performed. The fractal analysis of cone beam computed tomography (CBCT) represents a way to assess the quality of post-extraction bone regeneration. The purpose of this study was to analyze the alveolar bone changes after tooth extraction using fractal analysis on CBCT images. Methods: This retrospective study included pre- and post-extraction CBCTs at 3 months of 60 patients who underwent 100 extractions of first and/or second molars. Fractal analysis on CBCT images was performed using ImageJ, and the data obtained from the measurements were statistically processed. A multiple regression model was used to assess factors influencing bone remodeling. Results: Fractal analysis performed on CBCT images showed that most patients experienced advanced bone remodeling, this being more pronounced in those from rural areas, in the vertical plane at the mandible and at the second molar. The multiple regression model showed that the factors that play an important role in predicting bone resorption are represented by age group (age above 56 years old is associated with less bone resorption), location (bone resorption is more pronounced at the mandible level), and molar (bone resorption for the second molar is higher). Conclusions: Post-extraction bone changes were influenced by the age of the patient and by the location of the extraction, with the maxilla and first molar having better fractal analysis values compared to the mandible and second molar. These results emphasize the importance of training implantologists in CBCT evaluation to improve personalized implant-prosthetic treatment decisions.
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Affiliation(s)
- Antonia Samia Khaddour
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (R.E.G.); (M.O.C.); (I.R.M.); (E.C.D.)
| | - Sanda Mihaela Popescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (R.E.G.); (M.O.C.); (I.R.M.); (E.C.D.)
| | - Mihaela Ionescu
- Department of Medical Informatics and Biostatistics, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Alex Ioan Sălan
- Department of Oral and Maxillofacial Surgery, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Răzvan Eugen Ghiţă
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (R.E.G.); (M.O.C.); (I.R.M.); (E.C.D.)
| | - Melania Olimpia Cojocaru
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (R.E.G.); (M.O.C.); (I.R.M.); (E.C.D.)
| | - Iulia Roxana Marinescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (R.E.G.); (M.O.C.); (I.R.M.); (E.C.D.)
| | - Marina Olimpia Amărăscu
- Department of Dental Technology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania;
| | - Emma Cristina Draghici
- Department of Oral Rehabilitation, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (A.S.K.); (R.E.G.); (M.O.C.); (I.R.M.); (E.C.D.)
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Wili P, Rauber C, Saade A, Bliggenstorfer S, Ramirez‐Garmendia V, Schweizer R, Irastorza‐Landa A, Chappuis V, Zysset P. Primary Stability of Dental Implants in Human Jawbones: Experiments & FE Analyses. Clin Oral Implants Res 2025; 36:339-352. [PMID: 39670698 PMCID: PMC11891032 DOI: 10.1111/clr.14386] [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: 07/23/2024] [Revised: 10/04/2024] [Accepted: 11/18/2024] [Indexed: 12/14/2024]
Abstract
OBJECTIVES Primary stability (PS) is a key factor for promoting osseointegration and long-term success of dental implants particularly for immediate loading protocols. Beyond the current assessments of PS, an accurate pre-operative evaluation of PS would contribute to the improvement of surgical planning and treatment outcome. This study used biomechanical testing and homogenized finite element (hFE) analysis to objectively measure PS in the laboratory, and digitally estimate PS from prior μCT reconstructions. MATERIAL AND METHODS Thirty-five bone samples extracted from the jaws of two donors were examined. Twenty-two were finally evaluated for PS. After scanning of the samples with μCT, implants were inserted by two experienced surgeons, and various metrics such as μCT-based bone volume fraction (BV/TV), insertion torque (IT), and resonance frequency analysis (RFA) were assessed to determine PS. Mechanical tests were conducted to measure ultimate force (UFexp) as an objective indicator of PS while the hFE simulations were performed to estimate this same ultimate force (UFsim). RESULTS Higher correlation was found between UFsim and UFexp (R2 = 0.85) than between BV/TV and UFexp (R2 = 0.61), IT and UFexp (R2 = 0.50), and RFA and UFexp (R2 = 0.38). All variables demonstrated a statistically significant linear correlation with UFexp (p < 0.01). CONCLUSION UFsim turns out to be a more reliable and objective indicator of PS than IT and RFA. The hFE analysis requires prior μCT reconstructions and is currently limited by numerical convergence problems. Despite these limitations, pre-operative hFE analysis emerges as a promising tool with a higher accuracy for estimation of PS than state of care techniques.
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Affiliation(s)
- Patrik Wili
- ARTORG Centre for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
| | - Cedric Rauber
- ARTORG Centre for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
| | - Amal Saade
- Nobel Biocare Services AGKlotenSwitzerland
| | - Salomé Bliggenstorfer
- School of Dental Medicine, Department of Oral Surgery and Stomatology, Division of Oral Diagnostic SciencesUniversity of BernBernSwitzerland
| | - Valentina Ramirez‐Garmendia
- School of Dental Medicine, Department of Oral Surgery and Stomatology, Division of Oral Diagnostic SciencesUniversity of BernBernSwitzerland
| | | | | | - Vivianne Chappuis
- School of Dental Medicine, Department of Oral Surgery and Stomatology, Division of Oral Diagnostic SciencesUniversity of BernBernSwitzerland
| | - Philippe Zysset
- ARTORG Centre for Biomedical Engineering ResearchUniversity of BernBernSwitzerland
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Vautrin A, Thierrin R, Wili P, Voumard B, Klingler S, Chappuis V, Varga P, Zysset P. Homogenized finite element simulations can predict the primary stability of dental implants in human jawbone. J Mech Behav Biomed Mater 2024; 158:106688. [PMID: 39153410 DOI: 10.1016/j.jmbbm.2024.106688] [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: 06/01/2024] [Revised: 07/25/2024] [Accepted: 08/11/2024] [Indexed: 08/19/2024]
Abstract
Adequate primary stability is a pre-requisite for the osseointegration and long-term success of dental implants. Primary stability depends essentially on the bone mechanical integrity at the implantation site. Clinically, a qualitative evaluation can be made on medical images, but finite element (FE) simulations can assess the primary stability of a bone-implant construct quantitatively based on high-resolution CT images. However, FE models lack experimental validation on clinically relevant bone anatomy. The aim of this study is to validate such an FE model on human jawbones. Forty-seven bone biopsies were extracted from human cadaveric jawbones. Dental implants of two sizes (Ø3.5 mm and Ø4.0 mm) were inserted and the constructs were subjected to a quasi-static bending-compression loading protocol. Those mechanical tests were replicated with sample-specific non-linear homogenized FE models. Bone was modeled with an elastoplastic constitutive law that included damage. Density-based material properties were mapped based on μCT images of the bone samples. The experimental ultimate load was better predicted by FE (R2 = 0.83) than by peri-implant bone density (R2 = 0.54). Unlike bone density, the simulations were also able to capture the effect of implant diameter. The primary stability of a dental implant in human jawbones can be predicted quantitatively with FE simulations. This method may be used for improving the design and insertion protocols of dental implants.
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Affiliation(s)
- Antoine Vautrin
- AO Research Institute Davos, Switzerland; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Raphaël Thierrin
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Patrik Wili
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Benjamin Voumard
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Samuel Klingler
- School of Dental Medicine, Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | - Vivianne Chappuis
- School of Dental Medicine, Department of Oral Surgery and Stomatology, University of Bern, Bern, Switzerland
| | | | - Philippe Zysset
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
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Temur KT, Magat G, Cukurluoglu A, Onsuren AS, Ozcan S. Evaluation of mandibular trabecular bone by fractal analysis in pediatric patients with hypodontia of the mandibular second premolar tooth. BMC Oral Health 2024; 24:1005. [PMID: 39192307 DOI: 10.1186/s12903-024-04766-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: 05/01/2024] [Accepted: 08/16/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND It is still unclear whether the trabecular structure of the jaw is different in individuals with hypodontia than in those without hypodontia; this is important for clinicians. The aim was to determine whether the mandibular trabecular bone structure of children and adolescents with hypodontia differs from the control group by using the fractal analysis (FA) method in this study. METHODS A total of 138 panoramic radiographs of 69 cases and 69 control subjects (mean age 13.2 ± 10.1) were evaluated. The age and gender of subjects in the case and control groups were matched. Three regions of interest (ROIs) were selected from the panoramic radiographs. ROI1 refers to the center of the ramus rising above the mandibular foramen. ROI2 refers to the area between the apical level of the mandibular molar and the upper border of the mandibular canal. ROI3, the missing tooth region, refers to the apical third of the mesial side of the erupting or fully erupted permanent mandibular first molar. Mann-Whitney U and Wilcoxon tests were used. p < 0.05 was accepted for the significance value. RESULTS The mean fractal dimension (FD) values of ROI1, ROI2, and ROI3 were 1,25, 1,20, and 1,13, respectively. The means FD values obtained from the ramus region were higher than the other regions (p < 0.05). The FD values did not differ significantly according to gender and age (p > 0.05). The FD values of the case group were lower than the control group for ROI3 (p < 0.05). CONCLUSION The results of this study showed that the mandibular trabecular bone quality of pediatric patients with one missing tooth was different from the healthy group. The difference in the mean FD values from the ROIs indicates that the ramus has a denser structure than the mandibular corpus. Clinicians should factor this into their dental treatment planning process.
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Affiliation(s)
- Katibe Tugce Temur
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Niğde Ömer Halisdemir University, Niğde, Turkey.
| | - Guldane Magat
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Necmettin Erbakan University, Konya, Turkey
| | - Aykagan Cukurluoglu
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
| | | | - Sevgi Ozcan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Katıp Celebi University, İzmir, Turkey
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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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Teterina A, Niratisairak S, Morseth B, Bolstad N. General and local predictors of mandibular cortical bone morphology in adult females and males: the seventh survey of the Tromsø Study. Clin Oral Investig 2023; 27:6577-6587. [PMID: 37735212 PMCID: PMC10630240 DOI: 10.1007/s00784-023-05263-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/11/2023] [Indexed: 09/23/2023]
Abstract
OBJECTIVES To analyze factors predicting mandibular cortical width (MCW) and mandibular cortical index (MCI) in adult females and males. MATERIAL AND METHODS Data on 427 females and 335 males aged 40-84 from The Tromsø study: Tromsø7 were used. T-score, age, menopausal status (for females), remaining teeth, and periodontal status were analyzed in linear and logistic regression analyses as predictors of MCW and MCI, respectively. RESULTS T-score, age, and the number of remaining teeth significantly predicted MCW in females but not males. Standardized β coefficients were 0.286, -0.231, and 0.131, respectively. The linear regression model explained 24% of MCW variation in females. MCI in females was significantly predicted by T-score, age, and remaining teeth with the Wald values of 9.65, 6.17, and 5.83, respectively. The logistic regression model explained 16.3-23% of the variation in MCI in females. In males, T-score was the only significant predictor of the eroded cortex, and the logistic model explained only 4.3-5.8% of the variation in MCI. CONCLUSIONS The T-score demonstrated a stronger relationship with MCW and MCI than other factors in females, which supports the usefulness of those indices for osteoporosis screening. Conversely, the T-score exhibited no association with MCW and remained the only significant predictor of MCI in males, yet to a lesser extent than in females. CLINICAL RELEVANCE Understanding factors affecting mandibular cortical morphology is essential for further investigations of MCW and MCI usefulness for osteoporosis screening in females and males.
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Affiliation(s)
- Anna Teterina
- Department of Clinical Dentistry, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway.
| | - Sanyalak Niratisairak
- Department of Orthopaedics, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Biomechanics Laboratory, Rikshospitalet, Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway
| | - Napat Bolstad
- Department of Clinical Dentistry, Faculty of Health Sciences, University of Tromsø-The Arctic University of Norway, Tromsø, Norway
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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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Santos IG, Ramos de Faria F, da Silva Campos MJ, de Barros BÁC, Rabelo GD, Devito KL. Fractal dimension, lacunarity, and cortical thickness in the mandible: Analyzing differences between healthy men and women with cone-beam computed tomography. Imaging Sci Dent 2023; 53:153-159. [PMID: 37405205 PMCID: PMC10315234 DOI: 10.5624/isd.20230042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 04/11/2023] [Accepted: 04/14/2023] [Indexed: 07/06/2023] Open
Abstract
Purpose The objective of this study was to assess the fractal dimension, lacunarity, trabecular microarchitecture parameters, and cortical linear measurements in the mandibles of male and female individuals to identify differences between them. Materials and Methods In total, 116 cone-beam computed tomography scans of healthy individuals of different ages (57 men and 59 women, aged between 20 and 60 years) were selected. The following bone parameters were measured: 1) buccal, lingual, and basal cortical bone thickness in 5 standard parasagittal sections (the midline, the left and right sides of the lower lateral incisors, and the left and right sides of the lower canines); 2) the bone volume fraction of 10 sequential axial sections from each patient by creating a volume of interest in the area between the lower canines; and 3) fractal dimension and lacunarity using grayscale images of the same region of the volume of interest in the anterior mandible. Spearman correlation coefficients and the Mann-Whitney test were used. Results A significant and positive correlation was found between age and cortical thickness, especially in the region of the central incisors. Significant differences between sexes in terms of fractal dimension, lacunarity, and bone volume were found. Women revealed lower fractal dimension values and higher lacunarity and bone volume ratio values than men. Conclusion Fractal dimension, lacunarity, trabecular bone volume, and cortical thickness were different between men and women of different ages.
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Affiliation(s)
- Ingrid Garcia Santos
- School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Fernanda Ramos de Faria
- School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | | | | | - 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, Florianópolis, Santa Catarina, Brazil
| | - Karina Lopes Devito
- School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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Canger EM, Coşgunarslan A, Dilek F, Talay Çalış H. Evaluation of temporomandibular joint components and mandibular bone structure in ankylosing spondylitis patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 135:136-146. [PMID: 36272957 DOI: 10.1016/j.oooo.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 08/12/2022] [Accepted: 08/19/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVES The study aimed to investigate the mandible and temporomandibular joint (TMJ) in patients with ankylosing spondylitis (AS) who had no signs or symptoms of TMJ-related disease and compare them with a control group. STUDY DESIGN In total, 128 panoramic radiographs (63 patients with AS, 65 controls) were evaluated. Fractal analysis was conducted on the mandibular condyle (ROI1), angle of the mandible (ROI2), and the area adjacent to the mental foramen (ROI3). Articular eminence inclination (AEI) values were measured. Klemetti index (KI) evaluation of the mandibular cortex was also performed. RESULTS Fractal dimension (FD) values were significantly lower in the patients with AS than the controls in ROI1 and ROI2 (P = .001), but there were no significant differences between groups for FD in ROI3, AEI, or KI (P ≥ .09). No significant differences were found in any parameters between patients with AS with different disease durations (P ≥ .06). CONCLUSIONS Patients with AS displayed significantly lower FD values in condyles and the angle of the mandible and slightly lower AEI values; therefore, they should be examined routinely for TMJ disorders. Clinicians should be aware of the possibility of secondary osteoporosis in patients with AS and consider its probable effects on the mandible.
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Affiliation(s)
- Emin Murat Canger
- Department of Oral and Maxillofacial Radiology, Erciyes University Faculty of Dentistry, Melikgazi, Kayseri, Turkey
| | - Aykağan Coşgunarslan
- Department of Oral and Maxillofacial Radiology, Erciyes University Faculty of Dentistry, Melikgazi, Kayseri, Turkey.
| | - Fatma Dilek
- Department of Oral and Maxillofacial Radiology, Erciyes University Faculty of Dentistry, Melikgazi, Kayseri, Turkey
| | - Havva Talay Çalış
- Department of Physical Medicine and Rehabilitation, Kayseri City Hospital, Kocasinan, Kayseri, Turkey
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da Silva MEB, Dos Santos HS, Ruhland L, Rabelo GD, Badaró MM. Fractal analysis of dental periapical radiographs: A revised image processing method. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 135:669-677. [PMID: 36609053 DOI: 10.1016/j.oooo.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 10/19/2022] [Accepted: 11/25/2022] [Indexed: 12/05/2022]
Abstract
OBJECTIVE To assess trabecular bone structure as calculated with fractal analysis by 2 binarization processes: White and Rudolph's original method (WR.o) and a revised version (WR.r). Fractal dimension (FD) values calculated with WR.r (FD.r) and a gray-scale-based method (FD.f) were also compared. FD, histogram parameters, and lacunarity were compared by dentate status, jaw location, and sex. STUDY DESIGN Regions of interest from digital periapical radiographs were defined below the teeth roots and in the edentulous sites of 37 patients. Histograms were assessed for pixel values. Binarization was performed with WR.o and then with WR.r, in which the outliers were removed. FD was assessed using WR.r (FD.r) and (FD.f). Histograms were assessed to obtain pixel values. Lacunarity was calculated. RESULTS WR.r revealed fewer trabeculae, branches, and junctions than WR.o (P < .0001). The majority of the mean differences between FD.r and FD.f were within the 95% CI. Dentate areas had greater mean gray levels than partially edentulous areas (P = .0027). FD.f was higher in the mandible (P = .01), but gray-level SD (P < .0001) and lacunarity (P = .02) were greater in the maxilla. FD.f and lacunarity were higher (P = .0005) and lower (P = .0014) in males, respectively. CONCLUSION WR.r was effective in revealing skeletonized bone trabeculae by removing non-trabecular noise. FD.r and FD.f revealed good agreement. FD.f, histogram parameters, and lacunarity differed based on dentate status, jaw location, and sex.
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Affiliation(s)
| | | | - Letícia Ruhland
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Gustavo Davi Rabelo
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
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Kato CDNADO, Barra SG, Abreu LG, Machado VC, Pinheiro JDJV, Henriques JAS, Castro WH, Brasileiro CB, Mesquita RA. Fractal analysis of fibrous dysplasia and ossifying fibroma in 2D and 3D CBCT images. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2022; 34:791-799. [DOI: 10.1016/j.ajoms.2022.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/24/2025]
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13
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Is there an association between proton pump inhibitors and radiomorphometric parameters of the mandible? A preliminary study. Oral Radiol 2022; 38:586-593. [PMID: 35119594 DOI: 10.1007/s11282-022-00593-3] [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: 08/31/2021] [Accepted: 01/19/2022] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study aimed to analyze the association between the use of proton pump inhibitors (PPIs) and radiomorphometric parameters of trabecular and cortical bone of the mandible. METHODS A total of 64 patients (37 females and 27 males) using PPIs (PPI group) and 64 age- and gender-matched healthy individuals (control group) were included in this study. The analyzed radiomorphometric parameters were fractal dimension (FD), mandibular cortical width (MCW), and mandibular cortical index (MCI). RESULTS There were no significant differences in the mean FDs of selected regions and MCW between the two groups (p > 0.05). The mean MCW was 1.95 mm in the PPI group and 2 mm in the control group. The MCI C3 category, which represents the most porous state of the mandibular cortex, was 2.5 times more frequent in the PPI group (p = 0.002). PPI use duration did not correlate with FD or MCW. No significant differences were observed in FD, MCW, and MCI distribution according to PPI type (p > 0.05). CONCLUSIONS Although not all radiomorphometric parameters indicated osteoporotic effects of PPI use, the mandibular cortex of PPI users is prone to erosive defects.
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14
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Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis. Oral Radiol 2021; 37:189-208. [PMID: 33620644 DOI: 10.1007/s11282-021-00518-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Osteoporotic fractures are associated with an increased risk of subsequent fractures, a higher rate of mortality, and incremental medical costs. Incidental findings, which include some measurements related to the mandibular inferior cortex and the alveolar trabecular bone pattern of the mandible determined on panoramic radiographs, are considered to be a useful tool for identifying asymptomatic individuals at risk of having osteoporosis and/or fragility fractures. We undertook a worldwide literature survey and present the following clinical recommendations. Postmenopausal female dental patients with a mandibular inferior cortical width of less than 3 mm on panoramic radiographs may be at risk of having low skeletal bone mineral density (BMD) or osteoporosis, but not fragility fractures. In addition, those with a severely eroded mandibular inferior cortex may have an increased risk of having low skeletal BMD, osteoporosis, and fragility fractures. The alveolar trabecular bone pattern of the mandible might be useful for identifying female dental patients at risk of having fragility fractures, although further investigation is necessary to confirm this possibility. These incidental findings on panoramic radiographs, when used for identifying asymptomatic postmenopausal female patients at risk of having osteoporosis in general dental practice, may be helpful in reducing the incidence of first fractures, with a consequent reduction in the secondary fractures, medical costs, and mortality associated with osteoporotic fragility fractures, without incurring any additional cost.
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15
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Kato CNAO, Barra SG, Pereira MJC, Gomes LTF, Amaral TMP, Abreu LG, Brasileiro CB, Mesquita RA. Mandibular radiomorphometric parameters of women with cemento-osseous dysplasia. Dentomaxillofac Radiol 2020; 49:20190359. [PMID: 31846355 PMCID: PMC7213529 DOI: 10.1259/dmfr.20190359] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To compare the radiomorphometric parameters of mandibular trabecular and cortical bone of females with and without cemento-osseous dysplasia (COD). METHODS A retrospective cross-sectional paired study was conducted. Digital panoramic radiographs were obtained from females diagnosed in a public service of Oral Medicine. The participants were divided into two groups of 50 subjects each: females with a diagnosis of COD (COD group) and females without a diagnosis of COD (non-COD group), randomly chosen from the image database and paired for age. The radiomorphometric parameters analyzed were: mandibular cortical width (MCW), fractal dimension (FD) and mandibular cortical index (MCI). The paired t-test and Wilcoxon test were used to compare MCW and FD values and the McNemar-Bowker test compared the MCI. RESULTS The mean age of both groups was 46.84 ± 11.38 years. The median MCW index was 3.12 mm (2.15-4.55) for the COD group and 3.52 mm (1.90-4.70) for the non-COD group (p = 0.034). The mean FD value of the COD group (1.2039 ± 0.0926) was lower than that of the non-COD group (1.2472 ± 0.0894) in the anatomical region of the interest of mandibular cortical bone (p = 0.031), while no difference was detected in alveolar trabecular bone. The C3 degree of MCI was more frequent in the COD group (p = 0.009). CONCLUSION Females with COD had lower values of radiomorphometric parameters in mandibular cortical bone than females of the same age without COD. These results suggest that, in addition to the dental care recommended in the literature, COD females also require more attention and screening for low bone mineral density.
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Affiliation(s)
- Camila NAO Kato
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Sâmila G Barra
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Mateus JC Pereira
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Lucas TF Gomes
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Tânia MP Amaral
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Lucas G Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Cláudia B Brasileiro
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
| | - Ricardo A Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais 31270-901, Brazil
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Hayashi Y, Ito M, Imanishi Y, Watanabe K, Matsumoto K, Arai Y, Honda K. Use of experimental phantoms to determine the accuracy and reliability of mandibular cortical width measurements by panoramic radiography and cone-beam computed tomography. J Oral Sci 2020; 62:303-307. [DOI: 10.2334/josnusd.19-0307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Yusuke Hayashi
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Motohiro Ito
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Yusuke Imanishi
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kenichiro Watanabe
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kunihito Matsumoto
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Yoshinori Arai
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
| | - Kazuya Honda
- Department of Oral and Maxillofacial Radiology, Nihon University School of Dentistry
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17
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Kato CN, Barra SG, Tavares NP, Amaral TM, Brasileiro CB, Mesquita RA, Abreu LG. Use of fractal analysis in dental images: a systematic review. Dentomaxillofac Radiol 2019; 49:20180457. [PMID: 31429597 DOI: 10.1259/dmfr.20180457] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES This study reviewed the use of fractal analysis (FA) in dental images. METHODS A search was performed using PubMed, MEDLINE, LILACS, Web of Science and SCOPUS databases. The inclusion criteria were human studies in the English language, with no date restriction. RESULTS 78 articles were found in which FA was applied to panoramic radiographs (34), periapical radiographs (21), bitewing radiographs (4), cephalometric radiograph (1), cone beam CT (15), micro-CT (3), sialography (2), and ultrasound (2). Low bone mineral density (21) and systemic or local diseases (22) around the bone of dental implants were the main subjects of the study of FA. Various sizes and sites of the regions of interest were used to evaluate the bone structure. Different ways were used to treat the image and to calculate FA. FA of 43 articles showed significant differences in the comparison of groups, mainly between healthy and sick patients. CONCLUSIONS FA in Dentistry has been widely applied to the study of images. Panoramic and periapical radiographs were those most frequently used. The Image J software and the box-counting method were extensively adopted in the studies reviewed herein. Further studies are encouraged to improve clarification of the parameters that directly influence FA.
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Affiliation(s)
- Camila Nao Kato
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Sâmila G Barra
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Núbia Pk Tavares
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Tânia Mp Amaral
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Cláudia B Brasileiro
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo A Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lucas G Abreu
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
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18
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Balto KA, Gomaa MM, Feteih RM, AlAmoudi NM, Elsamanoudy AZ, Hassanien MA, Ardawi MSM. Dental Panoramic Radiographic Indices as a Predictor of Osteoporosis in Postmenopausal Saudi Women. J Bone Metab 2018; 25:165-173. [PMID: 30237996 PMCID: PMC6135653 DOI: 10.11005/jbm.2018.25.3.165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 08/13/2018] [Accepted: 08/15/2018] [Indexed: 01/27/2023] Open
Abstract
Background Many oral presentations of osteoporosis-a bone metabolic disease-were recorded. Thus, we aimed to assess panoramic radiomorphometric indices with bone mineral density (BMD) values among Saudi postmenopausal women and its importance in the prediction of osteoporosis. Methods A total of 431 Saudi women were enrolled in this study. Panoramic radiographs were obtained at the time of BMD measurement. Subjects were fatherly classified into; normal BMD, osteopenia, and osteoporosis groups. Serum follicle-stimulating hormone, luteinizing hormone (LH), estradiol (E2), 25-hydroxy-vitamin D (25[OH]D) and intact-parathyroid hormone were measured. Moreover, serum creatinine, calcium, and phosphate, together with serum osteocalcin (s-OC), procollagen type I N-terminal propeptide (s-PINP) and cross-linked C-terminal telopeptide of type 1 collagen (s-CTX) were measured. Receiver-operator curve (ROC) curve analysis for use of mandibular cortical width (MCW), panoramic mandibular index (PMI), and maxillary-mandibular ratio (M/M ratio) to differentiate women with osteoporosis or osteopenia from normal subjects was calculated. Cut off values of 4.6 at T score <−1 and 4.1 at T score ≤−2.5 were used. Results Body mass index is significantly low in the osteoporotic group. There is no significant difference in serum levels of LH, E2, calcium, phosphate, and 25(OH)D between the studied groups. Moreover, s-OC, C-terminal propeptide of procollagen type I, s-PINP, s-CTX, and urinary-CTX are significantly higher in osteoporosis than normal and osteopenia groups. ROC curve analysis revealed that MCW and PMI showed significant data while M/M ratio is non-significant. Conclusions It could be concluded that MCW as an important panoramic radiographic parameter can be used for prediction and diagnosis of osteoporosis in postmenopausal Saudi women with low BMD.
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Affiliation(s)
- Khaled Abdullah Balto
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Endodontics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Madiha Mahmoud Gomaa
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Endodontics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Rabab Mohammed Feteih
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Orthodontics and Maxillofacial Orthopedics, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Najlaa Mohammed AlAmoudi
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Ayman Zaky Elsamanoudy
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed Ahmed Hassanien
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Mohammed-Salleh M Ardawi
- Center of Excellence for Osteoporosis Research, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia.,Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
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19
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Kurşun-Çakmak EŞ, Bayrak S. Comparison of fractal dimension analysis and panoramic-based radiomorphometric indices in the assessment of mandibular bone changes in patients with type 1 and type 2 diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:184-191. [PMID: 29805101 DOI: 10.1016/j.oooo.2018.04.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 04/16/2018] [Accepted: 04/21/2018] [Indexed: 12/15/2022]
Abstract
OBJECTIVES This study compared the fractal dimension (FD) and radiomorphometric indices in the assessment of mandibular bone of patients with type 1 (T1 DM) and type 2 diabetes mellitus (T2 DM). STUDY DESIGN Panoramic radiographs of 104 patients were evaluated to calculate FD, mandibular cortical width (MCW), panoramic mandibular index (PMI), and mandibular cortical index (MCI) in the mandible. RESULTS No statistically significant differences were found in FD when T1 DM and T2 DM groups were compared with controls (P ≥ .168). Patients with T1 DM had significantly lower MCW (P < .001) and PMI (P = .030) compared with controls. Patients with T2 DM had no significant differences in MCW (P = .228) or PMI (P = .137) compared with controls. No significant differences were observed between patients with T1 DM and those with T2 DM for FD, MCW, and PMI (P > .05). In the T1 DM and T2 DM groups, there was a significant correlation between MCW and FD (P ≤ .011). No correlation was observed between FD and PMI in either the T1 DM group or the T2 DM group (P ≥ .142). No significant differences in MCI were observed between the DM groups and controls (P = .740) or between the T1 DM and T2 DM groups (P = 1.000). CONCLUSIONS The cortical and trabecular bone architectures of patients with T1 DM and T2 DM were not different. Patients with T1 DM had lower cortical measurements compared with controls.
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Affiliation(s)
| | - Seval Bayrak
- Abant İzzet Baysal University, Dentistry Faculty, Department of Dentomaxillofacial Radiology, Bolu, Turkey.
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Wanshi Arnoni V, Batista de Vasconcelos P, Sousa LGD, Ferreira B, Palinkas M, Acioli Righetti M, Pádua da Silva G, Aparecida Caldeira Monteiro S, Regalo SCH, Siéssere S. Evaluation of the electromyographic fatigue of the masseter and temporalis muscles in individuals with osteoporosis. Cranio 2018; 37:254-263. [PMID: 29327673 DOI: 10.1080/08869634.2017.1418618] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the electromyographic fatigue of the masseter and temporalis muscles in individuals with and without osteoporosis. METHODS Median frequency of the initial, mid, and final periods of the electromyographic signal in the 33 subjects with osteoporosis (OG) and 33 subjects without osteoporosis [control (CG)] was analyzed. RESULTS OG showed a decrease in median frequency along the electromyographic signal, with a significant difference for the right masseter: initial vs. mid periods, initial vs. final periods; left masseter: initial vs. final periods; temporal (right and left): initial vs. mid periods, initial vs. final periods, and mid vs. final periods. Percentage comparison of median frequency between the initial and mid periods and between initial and final periods in the OG showed a significant difference in the masticatory muscles. DISCUSSION The findings suggest that osteoporosis is associated with changes in the function of masticatory muscles, especially when measured by electromyographic fatigue.
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Affiliation(s)
- Veridiana Wanshi Arnoni
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Paulo Batista de Vasconcelos
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Luiz Gustavo de Sousa
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Bruno Ferreira
- b Department of Biomechanics, Medicine and Locomotive Apparatus Rehabilitation , Ribeirão Preto Medical University of São Paulo , São Paulo , Brazil
| | - Marcelo Palinkas
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Mariah Acioli Righetti
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Gabriel Pádua da Silva
- b Department of Biomechanics, Medicine and Locomotive Apparatus Rehabilitation , Ribeirão Preto Medical University of São Paulo , São Paulo , Brazil
| | - Solange Aparecida Caldeira Monteiro
- c Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Simone Cecilio Hallak Regalo
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Selma Siéssere
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
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