Investigation of mandibular cortical and trabecular bone in secondary polycythemia: case-control study

This study aimed to assess differences in mandibular cortical index (MCI) scores and fractal dimension (FD) values of mandibular trabecular bone between patients with secondary polycythemia and healthy controls using panoramic radiographs. A retrospective study was conducted with 196 individuals (98 cases, 98 healthy controls) aged 18–69. Panoramic radiographs were used to evaluate mandibular bone structure. FD values were calculated for regions of interest (ROIs) in the mandibular condyle, angulus, and interdental area using fractal analysis. MCI scores, classified as C1 (normal), C2 (mild resorption), or C3 (advanced resorption), were determined based on cortical morphology. FD values were significantly lower in the case group across all ROIs ( p < 0.05), indicating reduced trabecular bone complexity. The control group exhibited higher C1 scores, whereas the case group showed more C2 and C3 scores ( p < 0.05), reflecting greater cortical bone resorption in secondary polycythemia patients. Patients with secondary polycythemia displayed significant alterations in mandibular bone microarchitecture and cortical morphology compared to controls. These findings highlight the utility of panoramic radiographs in identifying early bone changes in polycythemia, aiding in the detection of osteoporosis and improving patient management strategies.