Evaluation of the Fractal Dimension in the Apical Region of Primary Teeth with Unilateral and Bilateral Infraocclusion

Abstract

Objectives: This study aims to employ fractal analysis (FA) to determine potential variations in the mandibular trabecular bone structure in the apical region among individuals with unilateral and bilateral infraocclusion of primary teeth compared to a control group. Materials and Methods: Forty-three carious primary teeth identified from panoramic radiographs taken for diagnostic purposes between January 2018 and December 2023 in the Department of Oral, Dental, and Maxillofacial Radiology of our institution were included in this investigation. Categorical variables were analyzed using the chi-square test, while continuous variables were assessed through Student paired t-tests and ANOVA tests. The threshold for statistical significance was set at p < 0.05. Results: The analysis revealed that the mean fractal dimension (FD) did not significantly differ between unilateral and bilateral infraocclusion groups based on gender (p > 0.05). Although the FDs in the apical regions of unilaterally infraoccluded teeth and their contralateral counterparts were observed to be lower, the disparity based on occlusion position did not reach statistical significance (p: 0.11). Moreover, no significant distinctions were observed in the FD or resorption levels between teeth exhibiting bilateral infraocclusion on the right and left sides (p: 0.877, p: 0.938). It was noted that the presence of an opposing tooth positively influenced the FD; however, this effect did not achieve statistical significance. Conclusions: While infraocclusion is prevalent in mandibular primary molars, this study did not observe any discernible alterations in the mandibular trabecular bone structure attributable to infraocclusion. Unilateral infraocclusion, in particular, was found to be a common and relatively benign condition. Additionally, numerical anomalies such as hypodontia and supernumerary teeth might exhibit associations with infraocclusion.