Evaluation of mandibular trabecular bone by fractal analysis on panoramic radiograph in paediatric patients with sleep bruxism

Abstract

Objective To evaluate the trabecular bone density in the mandible of paediatric patients diagnosed with sleep bruxism (SB) using the fractal analysis method on panoramic radiographs. Methods A total of 37 patients whose anamnesis and clinical signs were compatible with SB were diagnosed with SB using BiteStrip®. Three areas were identified on the panoramic radiographs of the patients: the geometric center of the condyle, the angulus region under the mandibular canal, and the distal region of the mental foramen. Regions of interest (ROIs) of 60 × 60 pixels were selected in these three locations, and fractal dimensions (FDs) were calculated. Results were compared with the control group. Results There was no statistically significant difference between the right and left FD values, and male and female FD values in all regions and both groups (p > .05). In the angulus (p = .03) and condyle (p = .03) regions, the SB group had a significantly higher FD value than the control group. There was no statistically significant difference between the SB and control groups in the corpus region (p = .98). A moderate negative correlation arose between age and condyle FD values among controls (r = −0.38, p = .02). Conclusion Fractal dimension values evaluating trabeculation of the mandibular bone are affected by SB in the angulus and condyle regions.

Comparative evaluation of trabecular bone structures of bruxist and non‐bruxist individuals with bone apposition in the mandible angle region by fractal analysis

“…We think that during this bone remodelling, the trabeculae become denser and form a more complex structure, and that's why the FD is calculated high. Similarly, Kolcakoglu et al 32 showed similar results to our study in the mandible angle region in children with sleep bruxism. In another study, a comparison of FD around the implant, in which a 1‐year follow‐up was made before and after prosthetic loading, was made and it was reported that FD increased after the remodelling of the bone against forces after loading 37 .…”

“…Trabecular bone has a higher metabolic activity than cortical bone and is, therefore, more determinant in the evaluation of changes in bone structure 31 . In our study, ROI 1, ROI 3, ROI 4, ROI 5 and ROI 6 were selected from the mandibular condyle and periradicular areas, and as in similar studies, no statistically significant FD difference was observed between the probable bruxist and the non‐bruxist G0 groups 5,9,32 . Although there are similar studies in which there are only significant differences between the right and left sides, the authors reported that there is a difference between the right and left sides depending on the unilateral chewing habit or the presence of the restored sides 5,9 .…”

“…31 In our study, ROI 1, ROI 3, ROI 4, ROI 5 and ROI 6 were selected from the mandibular condyle and periradicular areas, and as in similar studies, no statistically significant FD difference was observed between the probable bruxist and the non-bruxist G0 groups. 5,9,32 Although there are similar studies in which there are only significant differences between the right and left sides, the authors reported that there is a difference between the right and left sides depending on the unilateral chewing habit or the presence of the restored sides. 5,9 Periarticular bone, which is exposed to increasing forces in the condyle region, may transform into an enlarged bone area, increase-decrease in the bone density, and remodelling of the trabeculae structure may occur.…”

Evaluation of Bone Quality in Patients With Bruxism

“…In our study, FD values of the left condyle and left angulus area were found to be higher in individuals with bruxer than in individuals with non-bruxer disease [p < 0.05]. Similar to our study, Kolçakoğlu et al [20] compared 37 bruxer and 37 non-bruxer patients on 3 ROIs [the geometric center of the condyle, the angulus area below the mandibular canal and the distal area of the mental foramen] they determined in their study of pediatric patients [age range [5][6][7][8][9][10][11]. and angulus/condyle areas, they found that the bruxism group had a signi cantly higher FD value than the control group.…”

Radiomorfometric Analysis of Dental and Trabeculae Bone Changes in Bruxism Patients

“…In previous studies examining panoramic radiographs of patients diagnosed with bruxism, there were differences in the fractal dimension of the condyle. 3,6,11,21 In pediatric patients with sleep bruxism, the fractal dimension of the condyle was higher compared to the healthy group 21 , and it was lower in adult patients compared to the healthy group, but there was a statistically sig-nificant difference. 3,6 In a study examining trabecular changes in the condyle on panoramic radiographs of patients with a clinical diagnosis of TMJ disease, it was shown that healthy individuals had higher fractal dimension values compared to the patient group and lower fractal dimensions were seen in condyles.…”