Vücut kitle indeksinin mandibular kemik mimarisi üzerindeki etkileri: retrospektif fraktal boyut ve radyomorfometrik analiz

This retrospective study aimed to evaluate mandibular bone mineral density and bone trabecular structure using fractal dimension (FD) analysis and radiomorphometric indexes on dental panoramic radiographs, and to determine whether the results differed between groups with varying body mass index (BMI) levels. Panoramic radiographs of 127 individuals aged 18–45 (84 females and 43 males, with a mean age of 30.37 ± 8.4 years) were retrospectively selected from clinical records. Individuals were divided into four groups based on their BMI percentiles: normal, underweight, overweight, and obese. FD measurements, Mental Index (MI), and Panoramic Mandibular Index (PMI) were evaluated. Kruskal-Wallis Test, Pearson Chi-Square Test, and Wilcoxon Test were used in the comparison of parameters. MI and PMI values differed significantly among BMI groups (p = 0.005 and p = 0.025, respectively). Specifically, obese individuals had higher MI and PMI values compared to those in the other BMI categories. A statistically significant difference was also observed in FD premolar-canine values ​​among BMI categories (p < 0.001). However, no significant differences were found for FD premolar-molar, FD angulus, and FD condyle values ​​across BMI groups (p > 0.05). Mandibular cortex thickness (MI) values were thicker in obese and overweight adults, and PMI values were higher in obese individuals compared to lean individuals. However, only FD values measured in the premolar-canine region were observed to be lower in lean individuals compared to the other groups. The study findings demonstrate that BMI values ​​significantly affect mandibular cortical bone structure. Structural differences in cortical and trabecular bone may impact surgical procedures such as implant planning. Therefore, mandibular bone structure should be assessed preoperatively in cases of obesity and underweight to optimize primary stability and long-term success.