Research Article
BibTex RIS Cite

Year 2025, Volume: 15 Issue: 2, 427 - 433, 30.06.2025

Dicle Altındal , Sema Kaya

https://doi.org/10.33808/clinexphealthsci.1636403

Abstract

References

  • Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Clin Periodontol. 2018;45 (Suppl 20):149–161. https://doi.org/10.1111/jcpe.12945.
  • Kwon T, Lamster IB, Levin L. Current concepts in the management of periodontitis. Int Dent J. 2021;71(6):462–476. https://doi.org/10.1111/idj.12630.
  • Trindade D, Carvalho R, Machado V, Chambrone L, Mendes JJ, Botelho J. Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies. J Clin Periodontol. 2023;50(5):604–626. https://doi.org/10.1111/jcpe.13769
  • Ramseier CA, Anerud A, Dulac M, Lulic M, Cullinan MP, Seymour GJ, Faddy MJ, Bürgin W, Schätzle M, Lang NP. Natural history of periodontitis: Disease progression and tooth loss over 40 years. J Clin Periodontol. 2017;44(12):1182–1191. https://doi.org/10.1111/jcpe.12782.
  • van der Stelt PF. Better imaging: The advantages of digital radiography. J Am Dent Assoc. 2008;139 (Suppl):7-13. https://doi.org/10.14219/jada.archive.2008.0357.
  • Sener E, Cinarcik S, Baksi BG. Use of fractal analysis for the discrimination of trabecular changes between individuals with healthy gingiva or moderate periodontitis. J Periodontol. 2015;86(12):1364–1369. https://doi.org/10.1902/jop.2015.150004.
  • 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. 2020;49(2):1-12. https://doi.org/10.1259/dmfr.20180457.
  • Mishra S, Kumar M, Mishra L, Mohanty R, Nayak R, Das AC, Mishra S, Panda S, Lapinska B. Fractal dimension as a tool for assessment of dental implant stability-a scoping review. J Clin Med. 2022;11(14):1-20. https://doi.org/10.3390/jcm11144051.
  • Franciotti R, Moharrami M, Quaranta A, Bizzoca ME, Piattelli A, Aprile G, Perrotti V. Use of fractal analysis in dental images for osteoporosis detection: A systematic review and meta-analysis. Osteoporos Int. 2021;32(6):1041–1052. https://doi.org/10.1007/s00198-021-05852-3.
  • Aktuna Belgin C, Serindere G. Evaluation of trabecular bone changes in patients with periodontitis using fractal analysis: A periapical radiography study. J Periodontol. 2020;91(7):933–937. https://doi.org/10.1002/JPER.19-0452.
  • Kayaalti-Yüksek S, Büyük C, Ağirman M, Keleş G. Comparative examination of trabecular bone structure in healthy and diabetic patients with periodontitis using fractal analysis. Quintessence Int. 2024;55(3):192–200. https://doi.org/10.3290/j.qi.b4920297.
  • 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(9):1-14. https://doi.org/10.3390/biomedicines11092547.
  • Yarkac FU, Tassoker M, Atay UT, Azman D. Evaluation of trabecular bone in individuals with periodontitis using fractal analysis: An observational cross-sectional study. J Clin Exp Dent. 2023;15(12):1022–1028. https://doi.org/10.4317/jced.60921.
  • Eser S, Sarıbaş E. Anatomical assessment of the trabecular structure of the alveolar bone in periodontal disease by fractal analysis method. Folia Morphol (Warsz). 2024;83(1):157–167. https://doi.org/10.5603/FM.a2023.0023.
  • Shrout MK, Roberson B, Potter BJ, Mailhot JM, Hildebolt CF. A comparison of 2 patient populations using fractal analysis. J Periodontol. 1998;69(1):9–13. https://doi.org/10.1902/jop.1998.69.1.9.
  • Soltani P, Sami S, Yaghini J, Golkar E, Riccitiello F, Spagnuolo G. Application of fractal analysis in detecting trabecular bone changes in periapical radiograph of patients with periodontitis. Int J Dent. 2021;1:1-5. https://doi.org/10.1155/2021/3221448.
  • Updike SX, Nowzari H. Fractal analysis of dental radiographs to detect periodontitis-induced trabecular changes. J Periodontal Res. 2008;43(6):658–664. https://doi.org/10.1111/j.1600-0765.2007.01056.x.
  • 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(3):427–432. https://doi.org/10.1016/j.oooo.2022.09.041.
  • Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25(4):229–235.
  • Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol. 2018;89 (Suppl):74–84. https://doi.org/10.1002/JPER.17-0719.
  • Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane DF, Kirkwood KL, Kocher T, Kornman KS, Kumar PS, Loos BG, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour GJ, Teles R, Tonetti MS. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions: Classification and case definitions for periodontitis. J Periodontol. 2018;89 (Suppl 1):173–182. https://doi.org/10.1002/JPER.17-0721.
  • Kato CN, Barra SG, Pereira MJ, Gomes LT, Amaral TM, Abreu LG, Brasileiro CB, Mesquita RA. Mandibular radiomorphometric parameters of women with cemento-osseous dysplasia. Dentomaxillofac Radiol. 2020;49(4):1-9. https://doi.org/10.1259/dmfr.20190359.
  • White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(5):628–635. https://doi.org/10.1016/s1079-2104(99)70097-1.
  • Schwartz Z, Goultschin J, Dean DD, Boyan BD. Mechanisms of alveolar bone destruction in periodontitis. Periodontol 2000. 1997;14:158–172. https://doi.org/10.1111/j.1600-0757.1997.tb00196.x.
  • Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clin Oral Investig. 2015;19(2):519–524. https://doi.org/10.1007/s00784-014-1245-y.
  • Lang MS, Miyamoto T, Nunn ME. Validity of fractal analysis of implants in individuals with healthy and diseased peri-implant mucosa. Clin Oral Implants Res. 2020;31(11):1039–1046. https://doi.org/10.1111/clr.13650.
  • Dosdogru, EB, Ziyaettin, M, Ertürk AF, Ertürk AF. Investigation of the effect of periodontitis on trabecular bone structure by fractal analysis. Cureus. 2025;17(1):1-9. https://doi.org/ 10.7759/cureus.77833.

Mandibular Radiomorphometric Analysis in Patients with Different Stages of Periodontitis

Year 2025, Volume: 15 Issue: 2, 427 - 433, 30.06.2025

Dicle Altındal , Sema Kaya

https://doi.org/10.33808/clinexphealthsci.1636403

Abstract

Objective: This study aims to evaluate a possible change in the mandibular trabecular structure of patients diagnosed with different stages of periodontitis and to compare them with gingivitis and periodontally healthy individuals.
Methods: The periodontal diagnosis of 180 patients (90 females and 90 males) was made based on the 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Conditions. The patients were divided into six groups: periodontally healthy (n=30), gingivitis (n=30), Stage I (n=30), Stage II (n=30), Stage III (n=30), and Stage IV (n=30) periodontitis. Seven regions of interest (ROIs) were determined for fractal analysis (FA) on panoramic radiographs. Fractal dimension (FD) and mandibular cortical width (MCW) were evaluated.
Results: The mean age of the study population was 30.64±7.48 years. No statistically significant difference was observed among the groups in terms of FD. There was a statistically significant difference in gender distribution only for the MCW value (p<.05), and this value was found to be higher in male participants (23.87±4.59 mm vs. 22.50±3.75 mm). Although significant correlations were found between FD values of different regions (anterior FD, premolar FD, molar FD, angulus FD, and total FD), FD was not significantly correlated with age.
Conclusion: The results of this study suggest that FA calculated from panoramic radiographic images of periodontally healthy patients, gingivitis and different stages of periodontitis shows comparable results and indicates no superiority.

Keywords

Bone fractals mandible panoramic radiography periodontitis

Ethical Statement

The study protocol was approved by the Non-Interventional Clinical Research Ethics Committee at the University of Van Yuzuncu Yil (No: 2024/03-12, Date: 08/03/2024).

Thanks

The authors of this study would like to thank Prof. Dr. Sıddık Keskin for statistical analysis.

References

  • Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Clin Periodontol. 2018;45 (Suppl 20):149–161. https://doi.org/10.1111/jcpe.12945.
  • Kwon T, Lamster IB, Levin L. Current concepts in the management of periodontitis. Int Dent J. 2021;71(6):462–476. https://doi.org/10.1111/idj.12630.
  • Trindade D, Carvalho R, Machado V, Chambrone L, Mendes JJ, Botelho J. Prevalence of periodontitis in dentate people between 2011 and 2020: A systematic review and meta-analysis of epidemiological studies. J Clin Periodontol. 2023;50(5):604–626. https://doi.org/10.1111/jcpe.13769
  • Ramseier CA, Anerud A, Dulac M, Lulic M, Cullinan MP, Seymour GJ, Faddy MJ, Bürgin W, Schätzle M, Lang NP. Natural history of periodontitis: Disease progression and tooth loss over 40 years. J Clin Periodontol. 2017;44(12):1182–1191. https://doi.org/10.1111/jcpe.12782.
  • van der Stelt PF. Better imaging: The advantages of digital radiography. J Am Dent Assoc. 2008;139 (Suppl):7-13. https://doi.org/10.14219/jada.archive.2008.0357.
  • Sener E, Cinarcik S, Baksi BG. Use of fractal analysis for the discrimination of trabecular changes between individuals with healthy gingiva or moderate periodontitis. J Periodontol. 2015;86(12):1364–1369. https://doi.org/10.1902/jop.2015.150004.
  • 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. 2020;49(2):1-12. https://doi.org/10.1259/dmfr.20180457.
  • Mishra S, Kumar M, Mishra L, Mohanty R, Nayak R, Das AC, Mishra S, Panda S, Lapinska B. Fractal dimension as a tool for assessment of dental implant stability-a scoping review. J Clin Med. 2022;11(14):1-20. https://doi.org/10.3390/jcm11144051.
  • Franciotti R, Moharrami M, Quaranta A, Bizzoca ME, Piattelli A, Aprile G, Perrotti V. Use of fractal analysis in dental images for osteoporosis detection: A systematic review and meta-analysis. Osteoporos Int. 2021;32(6):1041–1052. https://doi.org/10.1007/s00198-021-05852-3.
  • Aktuna Belgin C, Serindere G. Evaluation of trabecular bone changes in patients with periodontitis using fractal analysis: A periapical radiography study. J Periodontol. 2020;91(7):933–937. https://doi.org/10.1002/JPER.19-0452.
  • Kayaalti-Yüksek S, Büyük C, Ağirman M, Keleş G. Comparative examination of trabecular bone structure in healthy and diabetic patients with periodontitis using fractal analysis. Quintessence Int. 2024;55(3):192–200. https://doi.org/10.3290/j.qi.b4920297.
  • 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(9):1-14. https://doi.org/10.3390/biomedicines11092547.
  • Yarkac FU, Tassoker M, Atay UT, Azman D. Evaluation of trabecular bone in individuals with periodontitis using fractal analysis: An observational cross-sectional study. J Clin Exp Dent. 2023;15(12):1022–1028. https://doi.org/10.4317/jced.60921.
  • Eser S, Sarıbaş E. Anatomical assessment of the trabecular structure of the alveolar bone in periodontal disease by fractal analysis method. Folia Morphol (Warsz). 2024;83(1):157–167. https://doi.org/10.5603/FM.a2023.0023.
  • Shrout MK, Roberson B, Potter BJ, Mailhot JM, Hildebolt CF. A comparison of 2 patient populations using fractal analysis. J Periodontol. 1998;69(1):9–13. https://doi.org/10.1902/jop.1998.69.1.9.
  • Soltani P, Sami S, Yaghini J, Golkar E, Riccitiello F, Spagnuolo G. Application of fractal analysis in detecting trabecular bone changes in periapical radiograph of patients with periodontitis. Int J Dent. 2021;1:1-5. https://doi.org/10.1155/2021/3221448.
  • Updike SX, Nowzari H. Fractal analysis of dental radiographs to detect periodontitis-induced trabecular changes. J Periodontal Res. 2008;43(6):658–664. https://doi.org/10.1111/j.1600-0765.2007.01056.x.
  • 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(3):427–432. https://doi.org/10.1016/j.oooo.2022.09.041.
  • Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975;25(4):229–235.
  • Chapple ILC, Mealey BL, Van Dyke TE, Bartold PM, Dommisch H, Eickholz P, Geisinger ML, Genco RJ, Glogauer M, Goldstein M, Griffin TJ, Holmstrup P, Johnson GK, Kapila Y, Lang NP, Meyle J, Murakami S, Plemons J, Romito GA, Shapira L, Tatakis DN, Teughels W, Trombelli L, Walter C, Wimmer G, Xenoudi P, Yoshie H. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Periodontol. 2018;89 (Suppl):74–84. https://doi.org/10.1002/JPER.17-0719.
  • Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane DF, Kirkwood KL, Kocher T, Kornman KS, Kumar PS, Loos BG, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour GJ, Teles R, Tonetti MS. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions: Classification and case definitions for periodontitis. J Periodontol. 2018;89 (Suppl 1):173–182. https://doi.org/10.1002/JPER.17-0721.
  • Kato CN, Barra SG, Pereira MJ, Gomes LT, Amaral TM, Abreu LG, Brasileiro CB, Mesquita RA. Mandibular radiomorphometric parameters of women with cemento-osseous dysplasia. Dentomaxillofac Radiol. 2020;49(4):1-9. https://doi.org/10.1259/dmfr.20190359.
  • White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(5):628–635. https://doi.org/10.1016/s1079-2104(99)70097-1.
  • Schwartz Z, Goultschin J, Dean DD, Boyan BD. Mechanisms of alveolar bone destruction in periodontitis. Periodontol 2000. 1997;14:158–172. https://doi.org/10.1111/j.1600-0757.1997.tb00196.x.
  • Zeytinoğlu M, İlhan B, Dündar N, Boyacioğlu H. Fractal analysis for the assessment of trabecular peri-implant alveolar bone using panoramic radiographs. Clin Oral Investig. 2015;19(2):519–524. https://doi.org/10.1007/s00784-014-1245-y.
  • Lang MS, Miyamoto T, Nunn ME. Validity of fractal analysis of implants in individuals with healthy and diseased peri-implant mucosa. Clin Oral Implants Res. 2020;31(11):1039–1046. https://doi.org/10.1111/clr.13650.
  • Dosdogru, EB, Ziyaettin, M, Ertürk AF, Ertürk AF. Investigation of the effect of periodontitis on trabecular bone structure by fractal analysis. Cureus. 2025;17(1):1-9. https://doi.org/ 10.7759/cureus.77833.
There are 27 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Radiology, Periodontics
Journal Section Articles
Authors

Dicle Altındal 0000-0001-6127-373X

Sema Kaya 0000-0002-6306-3901

Early Pub Date June 27, 2025
Publication Date June 30, 2025
Submission Date February 9, 2025
Acceptance Date June 20, 2025
Published in Issue Year 2025 Volume: 15 Issue: 2

Cite

APA Altındal, D., & Kaya, S. (2025). Mandibular Radiomorphometric Analysis in Patients with Different Stages of Periodontitis. Clinical and Experimental Health Sciences, 15(2), 427-433. https://doi.org/10.33808/clinexphealthsci.1636403
AMA Altındal D, Kaya S. Mandibular Radiomorphometric Analysis in Patients with Different Stages of Periodontitis. Clinical and Experimental Health Sciences. June 2025;15(2):427-433. doi:10.33808/clinexphealthsci.1636403
Chicago Altındal, Dicle, and Sema Kaya. “Mandibular Radiomorphometric Analysis in Patients With Different Stages of Periodontitis”. Clinical and Experimental Health Sciences 15, no. 2 (June 2025): 427-33. https://doi.org/10.33808/clinexphealthsci.1636403.
EndNote Altındal D, Kaya S (June 1, 2025) Mandibular Radiomorphometric Analysis in Patients with Different Stages of Periodontitis. Clinical and Experimental Health Sciences 15 2 427–433.
IEEE D. Altındal and S. Kaya, “Mandibular Radiomorphometric Analysis in Patients with Different Stages of Periodontitis”, Clinical and Experimental Health Sciences, vol. 15, no. 2, pp. 427–433, 2025, doi: 10.33808/clinexphealthsci.1636403.
ISNAD Altındal, Dicle - Kaya, Sema. “Mandibular Radiomorphometric Analysis in Patients With Different Stages of Periodontitis”. Clinical and Experimental Health Sciences 15/2 (June 2025), 427-433. https://doi.org/10.33808/clinexphealthsci.1636403.
JAMA Altındal D, Kaya S. Mandibular Radiomorphometric Analysis in Patients with Different Stages of Periodontitis. Clinical and Experimental Health Sciences. 2025;15:427–433.
MLA Altındal, Dicle and Sema Kaya. “Mandibular Radiomorphometric Analysis in Patients With Different Stages of Periodontitis”. Clinical and Experimental Health Sciences, vol. 15, no. 2, 2025, pp. 427-33, doi:10.33808/clinexphealthsci.1636403.
Vancouver Altındal D, Kaya S. Mandibular Radiomorphometric Analysis in Patients with Different Stages of Periodontitis. Clinical and Experimental Health Sciences. 2025;15(2):427-33.
 Download Cover Image

14639   14640