The Relationship of Fractal Dimension and Osseointegration: A Retrospective Radiologic Clinical Trial

ABSTRACT Purpose: The objective of this study was to evaluate the density of alveolar bone in the peri-implant area using fractal analysis on orthopantomograms, both prior to and following clinical osseointegration. Methods: Orthopantomograms were performed prior to the implant surgery and again four months postoperatively. Regions of interest at the mesial, distal, and apical sites of the implants were identified for analysis. The method by White and Rudolph was employed to calculate the fractal dimension. Subsequently, fractal dimension values were compared across all recorded measurements. Results: Statistical analyses revealed significant correlations between the mesial measurements before and after surgery, as well as between the distal measurements pre- and post-operatively, in comparison to the apical measurements over the same periods. Further subgroup analyses identified significant correlations in pre- and post-operative fractal dimension values specifically within the female subgroup, with notable distinctions observed between pre-mesial, post-mesial, and the average values before and after surgery (p < 0.05). Moreover, substantial differences were detected between the jaws (p < 0.05) and the specific locations within the jaws (p > 0.05), regarding the fractal dimensions measured pre- and post-operatively. Conclusion: Fractal analysis has demonstrated its reliability as a method for both clinical and radiological assessment of osseointegration.