Objectives: The purpose of this study was to evaluate fractal analysis as a tool to quantitatively determine the mandibular trabecular bone changes in patients with chronic renal failure (CRF). Methods: In the present study, fractal analysis was performed using ImageJ (National Institutes of Health, Bethesda, MD) program with box-counting method over panoramic radiographs of 25 patients (14 females and 11 males) with CRF and 26 healthy individuals (14 females and 12 males) as a control group. The fractal dimension (FD) values of the patients and healthy individuals were compared. In addition, average biochemical parameters [parathyroid hormone (PTH), calcium (Ca), phosphorus (P), product of Ca and P levels (CaxP), alkaline phosphatase (ALP), vitamin D] of the patients with CRF, as measured during the 3 months before the panoramic radiographs, were compared with FD values. Results: According to the results, FD values of the patients with CRF were found to be statistically lower than the control group (p , 0.05). The average PTH levels of the patients with CRF were 416.16 ± 310.3 pg ml 21 ; average Ca levels were 8.94 ± 1.2 mg dl 21 ; average P levels were 5.76 ± 1.7 mg dl 21 ; average CaxP values were 51.12 ± 15.03; average ALP levels were 83.44 ± 36.8 U l 21 ; and the average vitamin D values were 19.43 ± 9.7 ng ml 21 . In addition, there was no significant correlation between FD values and the biochemical parameters of the patients, and there was no correlation between age, gender and FD. Conclusions: The FD values of the patients with CRF were lower than those of the controls. This finding suggests that FD analysis might be a promising simple and cost-effective tool for evaluating trabecular bone structure.

This study shows that PP is not an uncommon anatomic variation and is a natural incidental finding on CBCT.

The anatomical structure of sella turcica can be studied effectively in CBCT images. Linear dimensions and shape of sella turcica in the current study can be used as reference standards for further investigations.

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US provides useful information about intraosseous jaw lesions and can be used with CBCT to image such lesions caused by buccal cortical thinning or perforation. Clinicians can take this information into consideration when evaluating intraosseous jaw pathology.

The pronounced increase in cardiac oxidative stress caused by periodontitis was due to an excessive increase in the production of reactive oxygen species, rather than due to decreased antioxidant capacity. The results indicate that periodontitis-related cardiac oxidative stress might be one of the mechanisms that contribute to the pathological process that leads to heart failure.

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