Evaluation of Cortical and Trabecular Bone Structure of the Mandible in Oral Contraceptive Users

Objective: Oral contraceptives (OCs) are widely prescribed hormonal agents that may influence bone homeostasis due to their estrogen content. Estrogen is essential for maintaining skeletal integrity, primarily by modulating osteoblast and osteoclast activity. This study aimed to evaluate whether combined oral contraceptive (COC) use affects mandibular bone microarchitecture using fractal dimension (FD) analysis and panoramic mandibular index (PMI) assessments.Methods: A case-control design was employed, analyzing digital panoramic radiographs from 290 women aged 18–50, including 145 COC users and 145 age-matched controls. FD values were determined from three mandibular sites: the condyle, angle, and interdental region. PMI values were also computed. Data were analyzed using SPSS software version 21.0 (IBM Corp., Armonk, NY, USA), p