Automated fractal analysis for mandibular bone evaluation in type 1 diabetes mellitus using a novel single click approach

This study aimed to assess mandibular bone alterations in individuals with Type 1 Diabetes Mellitus (T1DM) using a novel single-click fractal analysis module and to compare their fractal dimension (FD) values with those of healthy controls. A total of 184 panoramic radiographs from patients with T1DM-each of whom was receiving insulin therapy-and 184 age- and gender-matched healthy individuals were retrospectively evaluated. A newly developed Python-based module was used to calculate FD with a single click in six predefined mandibular regions of interest (ROIs), including gonial, interdental, and condylar areas. The significance of the test results was determined according to the p < 0.05 level. There were no statistically significant differences in FD values between groups in the condylar region (ROI 1 and 6). However, FD values in ROI 2, 3, 4, and 5-corresponding to the gonial and interdental areas-were significantly higher in the T1DM group compared to controls, suggesting microstructural differences in trabecular bone. The results indicate that T1DM is associated with region-specific alterations in mandibular trabecular bone architecture. The single-click fractal analysis module demonstrated efficient and standardized assessment of bone structure, offering a promising tool for clinical and research applications.