Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis

Introduction. Evaluation of detailed features of the supporting bone is an important step in diagnosis and treatment planning for teeth with clinical attachment loss. Fractal analysis can be used as a method for evaluating the complexity of trabecular bone structures. The aim of this study was to ev...

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Main Authors: Parisa Soltani, Sajad Sami, Jaber Yaghini, Ehsan Golkar, Francesco Riccitiello, Gianrico Spagnuolo
Format: Article
Language:English
Published: Wiley 2021-01-01
Series:International Journal of Dentistry
Online Access:http://dx.doi.org/10.1155/2021/3221448
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author Parisa Soltani
Sajad Sami
Jaber Yaghini
Ehsan Golkar
Francesco Riccitiello
Gianrico Spagnuolo
author_facet Parisa Soltani
Sajad Sami
Jaber Yaghini
Ehsan Golkar
Francesco Riccitiello
Gianrico Spagnuolo
author_sort Parisa Soltani
collection DOAJ
description Introduction. Evaluation of detailed features of the supporting bone is an important step in diagnosis and treatment planning for teeth with clinical attachment loss. Fractal analysis can be used as a method for evaluating the complexity of trabecular bone structures. The aim of this study was to evaluate the trabecular bone changes in periapical radiographs of patients with different stages of periodontitis using fractal analysis. Methods. This comparative cross-sectional study was performed on patients with and without clinical attachment loss in mandibular first molars. Teeth with clinical attachment loss were divided into mild, moderate, and severe periodontitis groups. Digital periapical radiographs were obtained from the mandibular first molars using the same exposure parameters. DICOM file of the radiographs was exported to ImageJ software for fractal analysis. Three regions of interest (ROIs) were considered in each radiograph: two proximal ROIs mesial and distal to the mandibular first molar and one apical ROI. Fractal dimension (FD) values were calculated using the fractal box counting approach. Statistical analysis was performed using the chi-square test, Mann–Whitney test, intraclass correlation coefficient, and ANOVA (α = 0.05). Results. FD values were significantly different between moderate and severe periodontitis and healthy periodontal bone (P<0.05), except for the distal ROI for moderate periodontitis cases (P=0.280). However, FD values of the supporting bone in periodontally healthy teeth and teeth with mild periodontitis did not show a statistically significant difference (P>0.05). Conclusion. Fractal analysis is a useful tool for evaluation of bone alterations in moderate and severe periodontitis, but was not able to detect the most initial radiographic bone signs of mild periodontitis.
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spelling doaj-art-c739a56c7e0f4b678c8e24127f9682e92025-02-03T01:27:19ZengWileyInternational Journal of Dentistry1687-87281687-87362021-01-01202110.1155/2021/32214483221448Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with PeriodontitisParisa Soltani0Sajad Sami1Jaber Yaghini2Ehsan Golkar3Francesco Riccitiello4Gianrico Spagnuolo5Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranStudents’ Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Periodontics, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, IranMedical Image and Signal Processing Research Center, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, ItalyDepartment of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples “Federico II”, Naples, ItalyIntroduction. Evaluation of detailed features of the supporting bone is an important step in diagnosis and treatment planning for teeth with clinical attachment loss. Fractal analysis can be used as a method for evaluating the complexity of trabecular bone structures. The aim of this study was to evaluate the trabecular bone changes in periapical radiographs of patients with different stages of periodontitis using fractal analysis. Methods. This comparative cross-sectional study was performed on patients with and without clinical attachment loss in mandibular first molars. Teeth with clinical attachment loss were divided into mild, moderate, and severe periodontitis groups. Digital periapical radiographs were obtained from the mandibular first molars using the same exposure parameters. DICOM file of the radiographs was exported to ImageJ software for fractal analysis. Three regions of interest (ROIs) were considered in each radiograph: two proximal ROIs mesial and distal to the mandibular first molar and one apical ROI. Fractal dimension (FD) values were calculated using the fractal box counting approach. Statistical analysis was performed using the chi-square test, Mann–Whitney test, intraclass correlation coefficient, and ANOVA (α = 0.05). Results. FD values were significantly different between moderate and severe periodontitis and healthy periodontal bone (P<0.05), except for the distal ROI for moderate periodontitis cases (P=0.280). However, FD values of the supporting bone in periodontally healthy teeth and teeth with mild periodontitis did not show a statistically significant difference (P>0.05). Conclusion. Fractal analysis is a useful tool for evaluation of bone alterations in moderate and severe periodontitis, but was not able to detect the most initial radiographic bone signs of mild periodontitis.http://dx.doi.org/10.1155/2021/3221448
spellingShingle Parisa Soltani
Sajad Sami
Jaber Yaghini
Ehsan Golkar
Francesco Riccitiello
Gianrico Spagnuolo
Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis
International Journal of Dentistry
title Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis
title_full Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis
title_fullStr Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis
title_full_unstemmed Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis
title_short Application of Fractal Analysis in Detecting Trabecular Bone Changes in Periapical Radiograph of Patients with Periodontitis
title_sort application of fractal analysis in detecting trabecular bone changes in periapical radiograph of patients with periodontitis
url http://dx.doi.org/10.1155/2021/3221448
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