Fractal Analysis of Trabecular Alveolar Bone with Intrabony and Furcation Defects Using Periapical Dental Radiographs

Mahmure Ayşe Tayman; Esma Sarıçam

doi:10.58600/eurjther2121

Authors

Mahmure Ayşe Tayman Department of Periodontology, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Türkiye https://orcid.org/0000-0001-8924-6725
Esma Sarıçam Department of Endodontics, Faculty of Dentistry, Ankara Yıldırım Beyazıt University, Ankara, Türkiye https://orcid.org/0000-0001-7701-4214

DOI:

https://doi.org/10.58600/eurjther2121

Keywords:

fractal analysis, fractal dimension, periodontal defect, periodontitis, periapical radiograph, trabecular bone

Abstract

Objective: Fractal analysis (FA) is a non-invasive method that quantitatively measures complex patterned geometric structures present throughout the image. Trabecular morphology of the alveolar bone and the changes occurring in the trabeculae in case of periodontitis can be detected with this method. To examine the periodontal defects in human skull bones using the FA, to compare them with healthy alveolar bone regions.

Methods: Furcation and intrabony defects were artificially created in the mandible alveolar bones (n:24). Periapical X-ray images of alveolar bone regions containing teeth with defects were taken using the parallel technique. Fractal analysis was performed by box-counting method using Image J software on images from areas containing healthy and defective trabecular bone.

Results: No statistically significant difference was found between the fractal values of healthy tissue and bifurcation defetcs and between the healthy tissue and intrabony defects (p>0.05).

Conclusion: Many factors may have affected the outcomes; patient selection, imaging methods, sample size, Region of interest (ROI) selection-location and size, individual and anatomical variations. These variables need to be standardized as much as possible and the limitations of the method need to be improved.

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References

Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, Flemmig TF, Garcia R, Giannobile WV, Graziani F, Greenwell H, Herrera D, Kao RT, Kebschull M, Kinane DF, Kirkwood KL, Kocher T, Kornman KS, Kumar PS, Loos BG, Machtei E, Meng H, Mombelli A, Needleman I, Offenbacher S, Seymour GJ, Teles R, Tonetti MS (2018) Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 89 Suppl 1:S173-S182. https://doi.org/10.1111/jcpe.12946

Özer N, Baksı Şen B (2021) Dental Radyografik Görüntülemede Üçüncü Boyut: Bir Literatür Güncellemesi. Atatürk Üniversitesi Diş Hekim Fakültesi Derg.14;31(4):652–661. https://doi.org/10.17567/ataunidfd.821983

Sener E, Cinarcik S, Baksi BG (2015) Use of Fractal Analysis for the Discrimination of Trabecular Changes Between Individuals With Healthy Gingiva or Moderate Periodontitis. J Periodontol. 86(12):1364–1369. https://doi.org/10.1902/jop.2015.150004

Ruttimann UE, Webber RL, Hazelrig JB (1992) Fractal dimension from radiographs of peridental alveolar bone: A possible diagnostic indicator of osteoporosis. Oral Surg Oral Med Oral Pathol. 74(1):98–110. https://doi.org/10.1016/0030-4220(92)90222-c

Mandelbrot BB (1967) How long is the coast of Britain? Statistical self-similarity and fractional dimension. Science. 156(3775):636–638. https://doi.org/10.1126/science.156.3775.636

Ruttimann UE, Ship JA (1990) The use of fractal geometry to quantitate bone structure from radiographs. J Dent Res. 69:287.

Doyle MD, Rabin H, Suri JS (1991) Fractal analysis as a means for the quantification of intramandibular trabecular bone loss from dental radiographs. Biostereometric Technology and Applications. 1380:227–235. https://doi.org/10.1117/12.25125

White SC, Rudolph DJ (1999) Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 88:628–635. https://doi.org/10.1016/s1079-2104(99)70097-1

Kato CN, Barra SG, Tavares NP, Amaral TM, Brasileiro CB, Mesquita RA, Abreu LG (2020) Use of fractal analysis in dental images: a systematic review. Dentomaxillofac Radiol. 49(2):20180457. https://doi.org/10.1259/dmfr.20180457

Eley BM, Cox SW (1998) Advances in periodontal diagnosis. 1. Traditional clinical methods of diagnosis. Br Dent J. 184(1):12-16. https://doi.org/10.1038/sj.bdj.4809529

Tayman MA, Kamburoğlu K, Öztürk E, Küçük Ö (2020) The accuracy of periapical radiography and cone beam computed tomography in measuring periodontal ligament space: Ex vivo comparative micro-CT study. Aust Endod J. 46(3):365-373. https://doi.org/10.1111/aej.12416

Alan A (2008) Kronik Periodontitisli Bireylerde Konvansiyonel Periapikal Radyografi Ve Dijital Subtractıon Radyografi Veri Etkinliklerinin Karşılaştırılması.

Zybutz M, Rapoport D, Laurell L, Persson GR (2000) Comparisons of clinical and radiographic measurements of inter-proximal vertical defects before and 1 year after surgical treatments. J Clin Periodontol. 27(3):179–186. https://doi.org/10.1034/j.1600-051x.2000.027003179.x

Aktuna Belgin C, Serindere G (2020) Evaluation of trabecular bone changes in patients with periodontitis using fractal analysis: A periapical radiography study. J Periodontol. 91(7):933–937. https://doi.org/10.1002/JPER.19-0452

Yaşar F, Akgünlü F (2014) The differences in panoramic mandibular indices and fractal dimension between patients with and without spinal osteoporosis. Dentomaxillofacial Radiol. 35(1):1–9. https://doi.org/10.1259/dmfr/97652136

Prouteau S, Ducher G, Nanyan P, Lemineur G, Benhamou L, Courteix D (2004) Fractal analysis of bone texture: a screening tool for stress fracture risk? Eur J Clin Invest. 34(2):137–142. https://doi.org/10.1111/j.1365-2362.2004.01300.x

Heo MS, Park KS, Lee SS, Choi SC, Koak JY, Heo SJ, Han CH, Kim JD (2002) Fractal analysis of mandibular bony healing after orthognathic surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 94(6):763–767. https://doi.org/10.1067/moe.2002.128972

Shrout MK, Roberson B, Potter BJ, Mailhot JM, Hildebolt CF (1998) A comparison of 2 patient populations using fractal analysis. J Periodontol. 69(1):9–13. https://doi.org/10.1902/jop.1998.69.1.9

Parissis N, Kondylidou-Sidira A, Tsirlis A, Patias P (2005) Conventional radiographs vs digitized radiographs: image quality assessment. Dentomaxillofac Radiol. 34(6):353–356. https://doi.org/10.1259/dmfr/99611204

Uğur Aydın Z, Ocak MG, Bayrak S, Göller Bulut D, Orhan K (2021) The effect of type 2 diabetes mellitus on changes in the fractal dimension of periapical lesion in teeth after root canal treatment: a fractal analysis study. Int Endod J. 73;54(2):181–189. https://doi.org/10.1111/iej.13409

Hayek E, Aoun G, Geha H, Nasseh I (2020) Image-based Bone Density Classification Using Fractal Dimensions and Histological Analysis of Implant Recipient Site. Acta Inform medica. 28(4):272–277. https://doi.org/10.5455/aim.2020.28.272-277

Shrout MK, Farley BA, Patt SM, Potter BJ, Hildebolt CF, Pilgram TK, Yokoyama-Crothers N, Dotson M, Hauser J, Cohen S, Kardaris E, Hanes P (1999) The effect of region of interest variations on morphologic operations data and gray-level values extracted from digitized dental radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 88(5):636–639. https://doi.org/10.1016/s1079-2104(99)70098-3

Updike SX, Nowzari H (2008) Fractal analysis of dental radiographs to detect periodontitis-induced trabecular changes. J Periodontal Res. 43(6):658–664. https://doi.org/10.1111/j.1600-0765.2007.01056.x

Lin JC, Amling M, Newitt DC, Selby K, Srivastav SK, Delling G, Genant HK, Majumdar S (1998) Heterogeneity of trabecular bone structure in the calcaneus using magnetic resonance imaging. Osteoporos Int. 8(1):16–24. https://doi.org/10.1007/s001980050043

Amer ME, Heo MS, Brooks SL, Benavides E (2012) Anatomical variations of trabecular bone structure in intraoral radiographs using fractal and particles count analyses. Imaging Sci Dent. 42(1):5-12. https://doi.org/10.5624/isd.2012.42.1.5

26 Sang-Yun C, Won-Jeong H, Eun-Kyung K (2001) Usefulness of fractal analysis for the diagnosis of periodontitis. Imaging Sci Dent. 31(1):35–42.

Coşgunarslan A, Aşantoğrol F, Canger EM, Medikoğlu EK, Soydan D (2019) Periodontitis ile ilişkili trabeküler kemik değişikliklerinin fraktal analiz ile incelenmesi. Selcuk Den J. 6:341-345.

Bollen AM, Taguchi A, Hujoel PP, Hollender LG (2001) Fractal dimension on dental radiographs. Dentomaxillofacial Radiol. 30(5):270–275. https://doi.org/10.1038/sj/dmfr/4600630

Molander B, Ahlqwist M GH (1995) Panoramic and restrictive intraoral radiography in comprehensive oral radiographic diagnosis. Eur J Oral Sci. 103(4):191–198. https://doi.org/10.1111/j.1600-0722.1995.tb00159.x

Shrout MK, Hildebolt CF, Vannier MW, Province M, Vahey EP (1990) Periodontal disease morbidity quantification. I. Optimal selection of teeth for periodontal bone loss surveys. J Periodontol. 61(10):618–622. https://doi.org/10.1902/jop.1990.61.10.618

Magat G, Ozcan Sener S (2019) Evaluation of trabecular pattern of mandible using fractal dimension, bone area fraction, and gray scale value: comparison of conebeam computed tomography and panoramic radiography. Oral Radiol. 35(1):35–42. https://doi.org/10.1007/s11282-018-0316-1

Lennon FE, Cianci GC, Cipriani NA, Hensing TA, Zhang HJ, Chen CT, Murgu SD, Vokes EE, Vannier MW, Salgia R (2015) Lung cancer -a fractal viewpoint. Nat Rev Clin Oncol. 12(1):664. https://doi.org/10.1038/nrclinonc.2015.108

Hua Y, Nackaerts O, Duyck J, Maes F, Jacobs R (2009) Bone quality assessment based on cone beam computed tomography imaging. Clin Oral Implants Res. 20(8):767–771. https://doi.org/10.1111/j.1600-0501.2008.01677.x

Hwang JJ, Lee JH, Han SS, Kim YH, Jeong HG, Choi YJ, Park W (2017) Strut analysis for osteoporosis detection model using dental panoramic radiography. Dentomaxillofac Radiol. :20170006. https://doi.org/10.1259/dmfr.20170006

Güngör E, Yildirim D, Çevik R (2016) Evaluation of osteoporosis in jaw bones using cone beam CT and dual-energy X-ray absorptiometry. J Oral Sci. 58:185–194. https://doi.org/10.2334/josnusd.15-0609

Geraets WG van der SP (2000) Fractal properties of bone. Dentomaxillofac Radiol. 29:144–153. https://doi.org/10.1038/sj/dmfr/4600524