Evaluation of Mandibular Bone Architecture in Individuals with Periodontitis Stage II Grade B Using Fractal Analysis

Objectives: Fractal analysis is a method employed in the medical and dental fields to examine the microarchitecture of bone tissue on a range of radiographic images. For this, it is achieved through the utilization of diverse image-processing techniques and mathematical operations. In the context of periodontal diseases, the evaluation of bone tissue plays a pivotal role in diagnosing the disease. The objective of this study was to analyze the mandibular bone of individuals with periodontitis stage II grade B on panoramic X-ray images using the fractal analysis method. Methods: In this study, the angulus region, the premolar/molar region, and the incisive region of the mandibular bone were identified as relevant regions for fractal analysis on panoramic images of 50 healthy individuals and 50 patients diagnosed with periodontitis stage II grade B by a specialist periodontologist. Consequently, fractal dimensions were calculated for 300 regions of interest across a total of 100 images. Fractal analysis was conducted using the Image J program, a freely available software, using the White and Rudolph method. The fractal dimension was measured in three regions of the mandible, and the results were statistically analyzed with Python using the independent groups’ t-test to evaluate the fractal dimension in the patient and control groups. Results: The statistical tests revealed no significant difference between the patient and control groups in terms of fractal dimensions in the angulus and molar regions (p>0.05). However, a difference was observed between the groups in the incisive region (p<0.05). Conclusion: The microarchitecture of bone tissue in the mandible is adversely affected by periodontal disease. Fractal analysis can provide supplementary data for evaluating bone in the field of periodontology.