The Investigation of Radiographic Findings of Mandibles on Panoramic Radiographs of Patients with Primary Hyperparathyroidism Using Fractal Analysis

Abstract

Objective: The basis of the research is the application of fractal analysis (FA) to panoramic radiographs of patients with primary hyperparathyroidism (PHPT). In addition, the relationship between the relevant biochemistry parameters and fractal values of healthy controls and patients with PHPT will be evaluated. Materials and Methods In the current study, FA was performed with ImageJ program on panoramic radiographs of 48 patients diagnosed with PHPT. Fractal dimension (FD) values of the patients and 48 healthy subjects were compared. In addition, biochemical [parathyroid hormone (PTH), serum calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), and vitamin D] parameters and FD values of both groups were analyzed with Mann–Whitney U -tests and Pearson correlation coefficient ( P < .05). Results FD values of four different angular areas were significantly lower in the patient group than in the healthy group ( P < .05). There was no statistically significant difference between the patient and control groups in the measurements between the apexes of the right and left premolar and molar teeth. The mean PTH, Ca, P, and vitamin D values of the patients with PHPT and control group were highly significant, and all the parameters of the patient group showed higher values than the control group except for the P values ( P < .001). In the patient group and control group, there was no significant difference between mean ALP values ( P = .48). No correlation was found between the two groups. Conclusion Bone biopsy is the gold standard method for the diagnosis of bone structure changes in patients with PHPT. However, it is not used routinely because it is an invasive method. The FA method applied to panoramic radiographs may be used as a noninvasive, easy-to-apply method to reveal the changes in the trabecular structure of the jaw bones of the patients.

Fractal characteristics of the trabecular pattern of the mandible in patients with renal transplantation

“…There is no consensus in studies on how changes in FD value affect the trabecular meshwork in the alveolar bone structure. Contrary to some studies, 32,33 which show an increase in FD value in some diseases that cause osteoporotic effects; many studies have shown that the FD value decreases in systemic diseases 12,15,19,27,34–37 . In a study in which bone structure analysis was performed by computerized microtomography in cats with CKD; it has been shown that there is a lower bone volume in the trabecular bone 38 .…”

“…Contrary to some studies, 32,33 which show an increase in FD value in some diseases that cause osteoporotic effects; many studies have shown that the FD value decreases in systemic diseases. 12,15,19,27,[34][35][36][37] In a study in which bone structure analysis was performed by computerized microtomography in cats with CKD; it has been shown that there is a lower bone volume in the trabecular bone. 38 Although different methods and calculations have been reported, the box-counting method for fractal analysis is the most preferred method.…”

Evaluation of trabecular changes following advancement genioplasty combined with or without bilateral sagittal split osteotomy by fractal analysis: a retrospective cohort study

“…In many studies in the literature in recent years, it has been shown that changes in bone structure can be examined with FD in conditions affecting bone structure such as osteoporosis, hyperparathyroidism, osteoarthritis or osteogenesis imperfecta [ 9 , 16 , 32 , 33 ]. In these studies, the differences in bone structure between healthy and sick individuals, as well as the effectiveness of treatments applied to sick individuals in some of the studies, were examined by comparing the changes in FD values occurring in the bone structure.…”