FRACTAL ANALYSIS OF TRABECULAR BONE PATTERN IN THE MANDIBLE AS AN INDICATOR OF OSTEOPOROSIS IN WOMEN - A CLINICAL STUDY
DOI:
https://doi.org/10.22159/ajpcr.2018.v11i2.22719Keywords:
Dental radiograph, Osteoporosis, Densitometry, Trabecular bone, FractalsAbstract
 Objectives: The objectives of this study were to estimate and compare the measurement of trabecular bone pattern in the mandible of normal and osteoporotic volunteers.
Methods: A 43 female volunteers were selected as osteoporotic (n=43) group and 30 as normal (n=30) group with age ranging from 25 to 60 years were enrolled based on bone mineral densitometer (BMD) in the calcaneus bone. A detailed case history followed by digital periapical radiograph was performed. The mandibular trabecular bone pattern in these volunteers was determined using Image J software, after standardizing the pixel size and locations of the region of interest for three different regions between the two groups. Statistical analysis using independent t-test and Pearson coefficient was performed.
Results: Results showed a significant difference in mean BMD values between the groups (0.52 in normal and −3.22 in osteoporotic). There are no significant differences in mean fractal dimension values between the groups (0.83 in normal and 0.82 in osteoporotic). Pearson correlation coefficient shows no significant correlation between the groups at three sites (p˃0.001).
Conclusion: Although trabecular bone microstructure on an intraoral radiograph plays a key role in defining osteoporosis, the present study did not show any significant difference in its architecture between normal and osteoporotic individuals as defined by BMD. Therefore, further studies should be performed using better-standardized resolution strategies and different estimation methods to gain more insight.
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Kumar AV, Joseph AK, Gokul G, Alex MP, Naveena G. Clinical outcome of calcium, Vitamin D3, and physiotherapy in osteoporotic population in the Nigari’s district. Int J Pharm Pharm Sci 2016;8:157-60.
Laugier P. An overview of bone sonometry. Int Congr Ser 2004;1274:23-32.
Oliveira ML, Pedrosa EF, Cruz AD, Haiter-Neto F, Paula FJ, Watanabe PC. Relationship between bone mineral density and trabecular bone pattern in postmenopausal osteoporotic Brazilian women. Clin Oral Invest 2012;17:1847-53.
Jett S, Shrout MK, Mailhot JM, Potter BJ, Borke JL. An evaluation of the origin of trabecular bone patterns using visual and digital image analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:598-604.
Ergün S, Saraçoglu A, Güneri P, Ozpinar B. Application of fractal analysis in hyperparathyroidism. Dentomaxillofac Radiol 2009;38:281-8.
Chen SK, Oviir T, Lin CH, Leu LJ, Cho BH, Hollender L. Digital imaging analysis with mathematical morphology and fractal dimension for evaluation of periapical lesions following endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:467-72.
Leite AF, de Souza Figueiredo PT, Caracas H, Sindeaux R, Guimarães AT, Lazarte L, et al. Systematic review with hierarchical clustering analysis for the fractal dimension in assessment of skeletal bone mineral density using dental radiograph. Oral Radiol 2014;31:1-13.
Kullenberg R, Falch JA. Prevalence of osteoporosis using bone mineral measurements at the calcaneus by dual X-ray and laser (DXL). Osteoporos Int 2003;14:823-7.
Carranza FA, Newman MG. Clinical Periodontology. 8th ed. Philadelphia, PA: WB Saunders; 1996. p. 297-313.
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;88:628-35.
Miraçi M, Demeti A, Ylli Z, Kelliçi S, Tarifa D. The cost-effectiveness of ibandronate and alendronate for the treatment of osteoporosis in a specialized clinic in Tirana. Int J Pharm Pharm Sci 2015;7:207-11.
Vogel JM, Wasnich RD, Ross PD. The clinical relevance of calcaneus bone mineral measurements: A review. Bone Miner 1988;5:35-58.
Martini G, Valenti R, Gennari L, Salvadori S, Galli B, Nuti R. Dual X-ray and laser absorptiometry of the calcaneus: Comparison with quantitative ultrasound and dual-energy X-ray absorptiometry. J Clin Densitom 2004;7:349-54.
Bender IB, Seltzer S. Roentgenographic and direct observation of experimental lesions in bone: II 1961. J Endod 2003;29:707-12.
Amer ME, Heo MS, Brooks SL, Benavides E. Anatomical variations of trabecular bone structure in intraoral radiographs using fractal and particles count analyses. Imaging Sci Dent 2012;42:5-12.
Yasar F, Akgünlü F. The differences in panoramic mandibular indices and fractal dimension between patients with and without spinal osteoporosis. Dentomaxillofac Radiol 2006;35:1-9.
Cha SY, Han WJ, Kim EK. Usefulness of fractal analysis for the diagnosis of periodontitis. Korean J Oral Maxillofac Radiol 2001;31:35-42.
Geraets WG, van der Stelt PF. Fractal properties of bone. Dentomaxillofac Radiol 2000;29:144-53.
Brewer J, Girolamo LD. Limitations of fractal dimension estimation algorithms with implications for cloud studies. Atmos Res 2006;82:433-54.
Chappard C, Brunet-Imbault B, Lemineur G, Giraudeau B, Basillais A, Harba R, et al. Anisotropy changes in post-menopausal osteoporosis: Characterization by a new index applied to trabecular bone radiographic images. Osteoporos Int 2005;16:1193-202.
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