Research Article
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Fractal analysis of mandibular condyle trabecular structure in children

Year 2025, Volume: 6 Issue: 2, 138 - 142, 23.03.2025
https://doi.org/10.47582/jompac.1644907

Abstract

Aims: The aim of this study was to investigate the changes in the trabecular structure of the mandibular condyle with age in children using fractal analysis (FA) on dental panoramic radiographs (DPRs) and to evaluate the fractal dimension (FD) differences according to age groups and gender.
Methods: In this retrospective study, 110 pediatric patients with DPR were divided into 2 groups according to age: 6-8 age group (n=55, mean: 6.8±0.704 years), 9-12 age group (n=55, mean: 11.18±1.775 years). FD values obtained from the right and left mandibular condyle were analyzed according to age and gender. For the calculation of FD, a 40x40 pixel square region of interest (ROI) was selected from the geometric center of both mandibular condyles. Image J version 1.52 software was used to obtain FD values by box counting method. Data were analyzed using IBM SPSS Statistics program. T-test was used to compare parametric data and Mann-Whitney U test was used to compare non-parametric data. Statistical significance level was determined as p<0.05.
Results: The mean FD of the right condyle was 1.046±0.086 and the mean FD of the left condyle was 1.201±1.205 in the 9-12 age group; the mean FD of the right condyle was 0.909±0.063 and the mean FD of the left condyle was 0.924±0.08 in the 6-8 age group. The mean FD values of both condyles increased with age and this increase was statistically significant (p<0.001). There was no significant difference between the mean FD values of the right and left condyles between genders in the same age group (p>0.05).
Conclusion: In the present study, FD values were determined for the trabecular structure of the mandibular condyle in healthy children. The results of the study showed that the FD values obtained from both mandibular condyles on DPRs in children increased with age.

Ethical Statement

Ethics: Human and animal rights statement All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. Ethical Statement: Ethical approval was obtained from Ankara Medipol University Non-interventional Clinical Research Ethics Committee (Protocol No: 63).

References

  • Howard JA. Temporomandibular joint disorders in children. Dental Clinics. 2013;57(1):99-127. doi:10.1016/j.cden.2012.10.001
  • Mérida-Velasco JR, Rodríguez-Vázquez JF, Mérida-Velasco JA, Sánchez-Montesinos I, Espín-Ferra J, Jiménez-Collado J. Development of the human temporomandibular joint. Anat Rec. 1999;255(1):20-33. doi:10.1002/(SICI)1097-0185(19990501)255:1<20::AID-AR4>3.0.CO;2-N
  • Bulut M, Tokuc M. Evaluation of the trabecular structure of mandibular condyles in children using fractal analysis. J Clin Pediatr Dent. 2021; 45(6):441-445. doi:10.17796/1053-4625-45.6.12
  • Bender ME, Lipin RB, Goudy SL. Development of the pediatric temporomandibular joint. Oral Maxillofac Surg Clin North Am. 2018; 30(1):1-9. doi:10.1016/j.coms.2017.09.002
  • Sharawy M. Developmental and clinical anatomy and physiology of the temporomandibular joint. Oral Maxillofac Surg. 2000;4:3-37.
  • Myall R, Dawson K, Egbert M. Maxillofacial injuries in children. Oral Maxillofac Surg. 2000;3:423-426.
  • Sena MF, Mesquita KSF, Santos FRR, Prevalence of temporomandibular dysfunction in children and adolescents. Rev Paul Pediatr. 2013;31(04): 538-545. doi:10.1590/S0103-05822013000400018
  • Yasar F, Akgünlü F. Fractal dimension and lacunarity analysis of dental radiographs. Dentomaxillofac Radiol. 2005;34(5):261-267. doi:10.1259/dmfr/85149245
  • Sanchez-Molina D, Velazquez-Ameijide J, Quintana V, et al. Fractal dimension and mechanical properties of human cortical bone. Med Eng Phys. 2013;35(5):576-582. doi:10.1016/j.medengphy.2012.06.024
  • Pothuaud L, Benhamou CL, Porion P, Lespessailles E, Harba R, Levitz P. Fractal dimension of trabecular bone projection texture is related to three-dimensional microarchitecture. J Bone Miner Res. 2000;15(4):691-699. doi:10.1359/jbmr.2000.15.4.691
  • Temur KT, Magat G, Cosgunarslan A, Ozcan S. Evaluation of jaw bone change in children and adolescents with rheumatic heart disease by fractal analysis. Niger J Clin Pract. 2024;27(2):260-267. doi:10.4103/njcp.njcp_346_23
  • Bostan SA, Özarslantürk S, Günaçar DN, Gonca M, Göller Bulut D, Ok Bostan H. Direct-acting oral anticoagulant/vitamin K antagonists: do they affect the trabecular and cortical structure of the Mandible? J Clin Densitom. 2024;27(3):101495. doi:10.1016/j.jocd.2024.101495
  • Tolga Suer B, Yaman Z, Buyuksarac B. Correlation of fractal dimension values with implant insertion torque and resonance frequency values at implant recipient sites. Int J Oral Maxillofac Implants. 2016;31(1):55-62. doi:10.11607/jomi.3965
  • Temur KT, Magat G, Cukurluoglu A, Onsuren AS, Ozcan S. Evaluation of mandibular trabecular bone by fractal analysis in pediatric patients with hypodontia of the mandibular second premolar tooth. BMC Oral Health. 2024;27;24(1):1005. doi:10.1186/s12903-024-04766-w
  • Crabtree NJ, Arabi A, Bachrach LK, et al. Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD pediatric official positions. J Clin Densitom. 2014;17(2):225-242. doi:10.1016/j.jocd.2014.01.003
  • Kolcakoglu K, Amuk M, Sirin Sarıbal G. Evaluation of mandibular trabecular bone by fractal analysis on panoramic radiograph in paediatric patients with sleep bruxism. Int J Paediatr Dent. 2022;32(6):776-784. doi:10.1111/ipd.12956
  • White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(5):628-635. doi:10.1016/s1079-2104(99)70097-1
  • Jolley L, Majumdar S, Kapila S. Technical factors in fractal analysis of periapical radiographs. Dentomaxillofac Radiol. 2006;35(6):393-397. doi: 10.1259/dmfr/30969642
  • Kotanli S, Ozturk EMA, Dogan ME, Uluısık NU. Evaluation of bone quality in patients with bruxism. Curr Med Imaging. 2024;20:e15734056299979. doi:10.2174/0115734056299979240927101222
  • Prouteau S, Ducher G, Nanyan P, Lemineur G, Benhamou L, Courteix D. Fractal analysis of bone texture: a screening tool for stress fracture risk? Eur J Clin Invest. 2004;34(2):137-142. doi:10.1111/j.1365-2362.2004. 01300.x
  • Apolinário AC, Sindeaux R, de Souza Figueiredo PT, et al. Dental panoramic indices and fractal dimension measurements in osteogenesis imperfecta children under pamidronate treatment. Dentomaxillofac Radiol. 2016;45(4):20150400. doi:10.1259/dmfr.20150400
  • Law AN, Bollen AM, Chen SK. Detecting osteoporosis using dental radiographs: a comparison of four methods. J Am Dent Assoc. 1996; 127(12):1734-1742. doi:10.14219/jada.archive.1996.0134
  • Magat G, Ozcan Sener S. Evaluation of trabecular pattern of mandible using fractal dimension, bone area fraction, and gray scale value: comparison of cone-beam computed tomography and panoramic radiography. Oral Radiol. 2019;35(1):35-42. doi:10.1007/s11282-018-0316-1
  • Kato CN, Barra SG, Tavares NP, et al. Use of fractal analysis in dental images: a systematic review. Dentomaxillofac Radiol. 2020;49:20180457. doi:10.1259/dmfr.20180457
  • Salem OH, Al-Sehaibany F, Preston CB. Aspects of mandibular morphology, with specific reference to the antegonial notch and the curve of Spee. J Clin Pediatr Dent. 2003;27(3):261-265. doi:10.17796/jcpd.27.3.m46h21173x62jx07
  • Shrout M, Hildebolt C, Potter B. The effect of varying the region of interest on calculations of fractal index. Dentomaxillofac Radiol. 1997; 26(5):295-298. doi:10.1038/sj.dmfr.4600260
  • Lee KI, Choi SC, Park TW, You DS. Fractal dimension calculated from two types of region of interest. Dentomaxillofac Radiol. 1999;28(5):284-289. doi:10.1038/sj/dmfr/4600458
  • Gunacar DN, Erbek SM, Aydınoglu S, Kose TE. Evaluation of the relationship between tooth decay and trabecular bone structure in pediatric patients using fractal analysis: a retrospective study. Eur Oral Res. 2022;5;56(2):67-73. doi:10.26650/eor.2022854959
  • Kurusu A, Horiuchi M, Soma K. Relationship between occlusal force and mandibular condyle morphology. Evaluated by limited cone-beam computed tomography. Angle Orthod. 2009;79(6):1063-1069. doi:10. 2319/120908-620R.1
  • Choi DY, Sun KH, Won SY, et al. Trabecular bone ratio of the mandibular condyle according to the presence of teeth: a micro-CT study. Surg Radiol Anat. 2012;34(6):519-526. doi:10.1007/s00276-012-0943-x
  • Guagnelli MA, Winzenrieth R, Lopez-Gonzalez D, McClung MR, Del Rio L, Clark P. Bone age as a correction factor for the analysis of trabecular bone score (TBS) in children. Arch Osteoporos. 2019;14(1):26. doi:10.1007/s11657-019-0573-6
  • Tercanlı H, Bolat Gümüş E. Evaluation of mandibular trabecular bone structure in growing children with class I, II, and III malocclusions using fractal analysis: a retrospective study. Int Orthod. 2024; 22(3):100875. doi:10.1016/j.ortho.2024.100875
  • Chugh T, Jain AK, Jaiswal RK, Mehrotra P. Bone density and its importance in orthodontics. J Orthod Res. 2013;3(2):92-97. doi:10.1016/j.jobcr.2013.01.001

Çocuklarda Mandibular Kondil Trabeküler Yapısının Fraktal Analizi

Year 2025, Volume: 6 Issue: 2, 138 - 142, 23.03.2025
https://doi.org/10.47582/jompac.1644907

Abstract

Amaç: Bu çalışmanın amacı, dental panoramik radyografiler (DPR) üzerinde fraktal analiz (FA) kullanarak çocuklarda mandibular kondilin trabeküler yapısında yaşla birlikte meydana gelen değişiklikleri araştırmak ve yaş gruplarına ve cinsiyete göre fraktal boyut (FD) farklılıklarını değerlendirmektir.
Yöntemler: Bu retrospektif çalışmada, DPR'li 110 pediatrik hasta yaşa göre 2 gruba ayrıldı: 6-8 yaş grubu (n=55, ortalama: 6.8 ± 0.704 yıl), 9-12 yaş grubu (n=55, ortalama: 11.18 ± 1.775 yıl). Sağ ve sol mandibular kondilden elde edilen FD değerleri yaş ve cinsiyete göre analiz edilmiştir. FD hesaplaması için her iki mandibular kondilin geometrik merkezinden 40x40 piksel kare görüntüleme alanı (ROI) seçildi. Kutu sayma yöntemiyle FD değerlerini elde etmek için Image J versiyon 1.52 yazılımı kullanıldı. Veriler IBM SPSS İstatistik programı kullanılarak analiz edildi. Parametrik verileri karşılaştırmak için T-testi, parametrik olmayan verileri karşılaştırmak için Mann-Whitney U testi kullanıldı. İstatistiksel anlamlılık düzeyi p<0.05 olarak belirlendi.
Bulgular: 9-12 yaş grubunda sağ kondil FD ortalaması 1.046±0.086, sol kondil FD ortalaması 1.201±1.205; 6-8 yaş grubunda sağ kondil FD ortalaması 0.909±0.063, sol kondil FD ortalaması 0.924±0.08 olarak bulundu. Her iki kondilin ortalama FD değerleri yaşla birlikte artmıştır ve bu artış istatistiksel olarak anlamlıdır (p<0.001). Aynı yaş grubunda cinsiyetler arasında sağ ve sol kondillerin ortalama FD değerleri arasında anlamlı bir fark yoktu (p>0.05).
Sonuç: Bu çalışmada, sağlıklı çocuklarda mandibular kondilin trabeküler yapısı için FD değerleri belirlendi. Çalışma sonuçları, çocuklarda DPR'lerde her iki mandibular kondilden elde edilen FD değerlerinin yaşla birlikte arttığını gösterdi.

References

  • Howard JA. Temporomandibular joint disorders in children. Dental Clinics. 2013;57(1):99-127. doi:10.1016/j.cden.2012.10.001
  • Mérida-Velasco JR, Rodríguez-Vázquez JF, Mérida-Velasco JA, Sánchez-Montesinos I, Espín-Ferra J, Jiménez-Collado J. Development of the human temporomandibular joint. Anat Rec. 1999;255(1):20-33. doi:10.1002/(SICI)1097-0185(19990501)255:1<20::AID-AR4>3.0.CO;2-N
  • Bulut M, Tokuc M. Evaluation of the trabecular structure of mandibular condyles in children using fractal analysis. J Clin Pediatr Dent. 2021; 45(6):441-445. doi:10.17796/1053-4625-45.6.12
  • Bender ME, Lipin RB, Goudy SL. Development of the pediatric temporomandibular joint. Oral Maxillofac Surg Clin North Am. 2018; 30(1):1-9. doi:10.1016/j.coms.2017.09.002
  • Sharawy M. Developmental and clinical anatomy and physiology of the temporomandibular joint. Oral Maxillofac Surg. 2000;4:3-37.
  • Myall R, Dawson K, Egbert M. Maxillofacial injuries in children. Oral Maxillofac Surg. 2000;3:423-426.
  • Sena MF, Mesquita KSF, Santos FRR, Prevalence of temporomandibular dysfunction in children and adolescents. Rev Paul Pediatr. 2013;31(04): 538-545. doi:10.1590/S0103-05822013000400018
  • Yasar F, Akgünlü F. Fractal dimension and lacunarity analysis of dental radiographs. Dentomaxillofac Radiol. 2005;34(5):261-267. doi:10.1259/dmfr/85149245
  • Sanchez-Molina D, Velazquez-Ameijide J, Quintana V, et al. Fractal dimension and mechanical properties of human cortical bone. Med Eng Phys. 2013;35(5):576-582. doi:10.1016/j.medengphy.2012.06.024
  • Pothuaud L, Benhamou CL, Porion P, Lespessailles E, Harba R, Levitz P. Fractal dimension of trabecular bone projection texture is related to three-dimensional microarchitecture. J Bone Miner Res. 2000;15(4):691-699. doi:10.1359/jbmr.2000.15.4.691
  • Temur KT, Magat G, Cosgunarslan A, Ozcan S. Evaluation of jaw bone change in children and adolescents with rheumatic heart disease by fractal analysis. Niger J Clin Pract. 2024;27(2):260-267. doi:10.4103/njcp.njcp_346_23
  • Bostan SA, Özarslantürk S, Günaçar DN, Gonca M, Göller Bulut D, Ok Bostan H. Direct-acting oral anticoagulant/vitamin K antagonists: do they affect the trabecular and cortical structure of the Mandible? J Clin Densitom. 2024;27(3):101495. doi:10.1016/j.jocd.2024.101495
  • Tolga Suer B, Yaman Z, Buyuksarac B. Correlation of fractal dimension values with implant insertion torque and resonance frequency values at implant recipient sites. Int J Oral Maxillofac Implants. 2016;31(1):55-62. doi:10.11607/jomi.3965
  • Temur KT, Magat G, Cukurluoglu A, Onsuren AS, Ozcan S. Evaluation of mandibular trabecular bone by fractal analysis in pediatric patients with hypodontia of the mandibular second premolar tooth. BMC Oral Health. 2024;27;24(1):1005. doi:10.1186/s12903-024-04766-w
  • Crabtree NJ, Arabi A, Bachrach LK, et al. Dual-energy X-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD pediatric official positions. J Clin Densitom. 2014;17(2):225-242. doi:10.1016/j.jocd.2014.01.003
  • Kolcakoglu K, Amuk M, Sirin Sarıbal G. Evaluation of mandibular trabecular bone by fractal analysis on panoramic radiograph in paediatric patients with sleep bruxism. Int J Paediatr Dent. 2022;32(6):776-784. doi:10.1111/ipd.12956
  • White SC, Rudolph DJ. Alterations of the trabecular pattern of the jaws in patients with osteoporosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88(5):628-635. doi:10.1016/s1079-2104(99)70097-1
  • Jolley L, Majumdar S, Kapila S. Technical factors in fractal analysis of periapical radiographs. Dentomaxillofac Radiol. 2006;35(6):393-397. doi: 10.1259/dmfr/30969642
  • Kotanli S, Ozturk EMA, Dogan ME, Uluısık NU. Evaluation of bone quality in patients with bruxism. Curr Med Imaging. 2024;20:e15734056299979. doi:10.2174/0115734056299979240927101222
  • Prouteau S, Ducher G, Nanyan P, Lemineur G, Benhamou L, Courteix D. Fractal analysis of bone texture: a screening tool for stress fracture risk? Eur J Clin Invest. 2004;34(2):137-142. doi:10.1111/j.1365-2362.2004. 01300.x
  • Apolinário AC, Sindeaux R, de Souza Figueiredo PT, et al. Dental panoramic indices and fractal dimension measurements in osteogenesis imperfecta children under pamidronate treatment. Dentomaxillofac Radiol. 2016;45(4):20150400. doi:10.1259/dmfr.20150400
  • Law AN, Bollen AM, Chen SK. Detecting osteoporosis using dental radiographs: a comparison of four methods. J Am Dent Assoc. 1996; 127(12):1734-1742. doi:10.14219/jada.archive.1996.0134
  • Magat G, Ozcan Sener S. Evaluation of trabecular pattern of mandible using fractal dimension, bone area fraction, and gray scale value: comparison of cone-beam computed tomography and panoramic radiography. Oral Radiol. 2019;35(1):35-42. doi:10.1007/s11282-018-0316-1
  • Kato CN, Barra SG, Tavares NP, et al. Use of fractal analysis in dental images: a systematic review. Dentomaxillofac Radiol. 2020;49:20180457. doi:10.1259/dmfr.20180457
  • Salem OH, Al-Sehaibany F, Preston CB. Aspects of mandibular morphology, with specific reference to the antegonial notch and the curve of Spee. J Clin Pediatr Dent. 2003;27(3):261-265. doi:10.17796/jcpd.27.3.m46h21173x62jx07
  • Shrout M, Hildebolt C, Potter B. The effect of varying the region of interest on calculations of fractal index. Dentomaxillofac Radiol. 1997; 26(5):295-298. doi:10.1038/sj.dmfr.4600260
  • Lee KI, Choi SC, Park TW, You DS. Fractal dimension calculated from two types of region of interest. Dentomaxillofac Radiol. 1999;28(5):284-289. doi:10.1038/sj/dmfr/4600458
  • Gunacar DN, Erbek SM, Aydınoglu S, Kose TE. Evaluation of the relationship between tooth decay and trabecular bone structure in pediatric patients using fractal analysis: a retrospective study. Eur Oral Res. 2022;5;56(2):67-73. doi:10.26650/eor.2022854959
  • Kurusu A, Horiuchi M, Soma K. Relationship between occlusal force and mandibular condyle morphology. Evaluated by limited cone-beam computed tomography. Angle Orthod. 2009;79(6):1063-1069. doi:10. 2319/120908-620R.1
  • Choi DY, Sun KH, Won SY, et al. Trabecular bone ratio of the mandibular condyle according to the presence of teeth: a micro-CT study. Surg Radiol Anat. 2012;34(6):519-526. doi:10.1007/s00276-012-0943-x
  • Guagnelli MA, Winzenrieth R, Lopez-Gonzalez D, McClung MR, Del Rio L, Clark P. Bone age as a correction factor for the analysis of trabecular bone score (TBS) in children. Arch Osteoporos. 2019;14(1):26. doi:10.1007/s11657-019-0573-6
  • Tercanlı H, Bolat Gümüş E. Evaluation of mandibular trabecular bone structure in growing children with class I, II, and III malocclusions using fractal analysis: a retrospective study. Int Orthod. 2024; 22(3):100875. doi:10.1016/j.ortho.2024.100875
  • Chugh T, Jain AK, Jaiswal RK, Mehrotra P. Bone density and its importance in orthodontics. J Orthod Res. 2013;3(2):92-97. doi:10.1016/j.jobcr.2013.01.001
There are 33 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Radiology
Journal Section Research Articles [en] Araştırma Makaleleri [tr]
Authors

Elif Meltem Aslan 0000-0002-1737-9585

Gülsevim Oda 0000-0002-3205-5028

Publication Date March 23, 2025
Submission Date February 22, 2025
Acceptance Date March 17, 2025
Published in Issue Year 2025 Volume: 6 Issue: 2

Cite

AMA Aslan EM, Oda G. Fractal analysis of mandibular condyle trabecular structure in children. J Med Palliat Care / JOMPAC / jompac. March 2025;6(2):138-142. doi:10.47582/jompac.1644907

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