Evaluation of 3-year changes in panoramic radiomorphometric indices and fractal dimension values in primary hyperparathyroidism patients

In a 3-year age- and gender-matched comparison, PHPT was associated with consistently lower AI and reduced FD in the mandibular angle, while other indices and regional FDs were largely unchanged. These findings identify panoramic AI and ROI2-FD as adjunctive, non-invasive markers that could prompt biochemical evaluation when clinical suspicion exists; confirmation and clinical integration require larger multicenter prospective studies with concurrent biochemical profiling.