Evaluation of the effect of menopause on mandibular cortical and trabecular bone structure using panoramic radiographs in patients with periodontitis

BackgroundMenopause and periodontitis can lead to changes in mandibular bone structure. Fractal dimension (FD) and radiomorphometric indices, which are widely are used to assess such changes.ObjectiveThis study aimed to evaluate mandibular trabecular bone using fractal analysis and cortical bone using radiomorphometric indices on panoramic radiographs of individuals with and without periodontitis during the perimenopausal and postmenopausal periods.MethodsThis retrospective study used panoramic radiographs from 60 females, categorized into four groups: perimenopausal and periodontally healthy (PERI-H); perimenopausal with periodontitis (PERI-P); postmenopausal and periodontally healthy (POST-H); postmenopausal with periodontitis (POST-P). Radiomorphometric indices and FD were measured bilaterally on selected condylar (F1, F6) and gonial regions (F2, F5), as well as between the first molar and second premolar teeth (F3, F4) bilaterally.ResultsIn the F3 and F4 regions, the POST-P group exhibited lower FD values compared to the PERI-H group (p = 0.035, p = 0.001, respectively). In the F1 region, significantly lower FD values were observed in the POST-P group versus the PERI-H, PERI-P and POST- H groups (p = 0.017, p = 0.011 and p = 0.017, respectively), and the POST-H group showed significantly lower FD values than the PERI-H group (p = 0.011). Cortical bone classification showed that C1 was most common in the PERI-H group (66.7%), C2 in the POST-H and POST-P groups (60.0%, 66.7%, respectively), and C3 in the POST-P group (26.7%) (p = 0.004).ConclusionsPostmenopausal females exhibited greater bone resorption in the alveolar region and the right condyle, and also showed lower FD values compared to perimenopausal females. Additionally, females with periodontitis exhibited lower fractal dimension values and increased bone porosity compared to the healthy group.