Evaluation of fractal analysis of trabecular bone region of lesioned and healthy lower permanent first molars according to age and gender on panoramic radiographic images

Aim: Evaluation of radiographs in dentistry is an important procedure for diagnosis, treatment plan and success of dental procedures. In recent years, the fractal analysis method has been frequently used to examine the changes caused by pathologies and diseases in the trabecular structure of the jaw bones. It is stated that the data obtained as a result of fractal analysis is associated with changes in bone density and reflects mineral loss in bone. The aim of this study is to evaluate and compare trabecular bone fractal dimension values of periapical lesioned and healthy lower permanent first molars according to age and gender, using panoramic radiographs. Material and Method: In our study, the panoramic radiographs of a total of 216 patients aged 6-16 years who applied to Dicle University Faculty of Dentistry Department of Pedodontics in 2022 were retrospectively examined. Fractal analysis was applied to ROIs determined in 25x25 pixel size from two separate regions on each digital panoramic radiograph (from the trabecular bone region at the apex of the periapical lesion and the healthy first molar tooth), using the ImageJ program, and fractal dimension calculations were made. Necessary statistical analyzes were performed. The significance level was taken as p<0,05. Result: According to the study results, the average fractal dimension value of the lesioned region is 1,106, while the average fractal dimension value of the healthy region is 1,116. There was no statistically significant difference between the fractal dimension values of the lesioned and healthy groups (p>0,05). No statistically significant relationship was detected between fractal dimension values and age and gender (p>0,05). Conclusion: Although fractal analysis is a reliable method, it is of great importance to integrate histological and clinical parameters into studies in order to achieve consensus among researchers. Keywords: Periapical Lesion, Panoramic Radiography, Fractal Analysis, ImageJ, ROI