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Image-based Bone Density Classification Using Fractal Dimensions and Histological Analysis of Implant Recipient Site.

Elie Hayek1, Georges Aoun1, Hassem Geha2

  • 1Department of Oral Medicine and Maxillofacial Radiology, Faculty of Dental Medicine, Lebanese University, Beirut, Lebanon.

Acta Informatica Medica : AIM : Journal of the Society for Medical Informatics of Bosnia & Herzegovina : Casopis Drustva Za Medicinsku Informatiku Bih
|February 25, 2021
PubMed
Summary

Dental implant success relies on alveolar bone density. Fractal dimension analysis of preoperative radiographs can reliably predict bone density at implant sites, aiding surgical planning.

Keywords:
Fractal dimensionbone densitybone specimenperiapical radiograph

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Area of Science:

  • Biomedical Engineering
  • Oral and Maxillofacial Surgery
  • Radiology

Background:

  • Alveolar bone quality and density are critical for dental implant stability and load-bearing capacity.
  • Preoperative radiographs are commonly used to assess bone parameters before implant placement.

Purpose of the Study:

  • To compare radiographic bone density using fractal dimension with histological bone density from harvested specimens.
  • To determine the reliability of fractal dimension for classifying bone density in the maxillary and mandibular posterior regions prior to dental implant surgery.

Main Methods:

  • Intra-oral radiographs (Photo Stimulable Phosphor Plate) were taken of edentulous sites in 50 male patients (25 maxilla, 25 mandible).
  • Fractal dimension (FD) analysis was performed on the region of interest at implant recipient sites.
  • Bone core specimens were histologically analyzed for density (bone mass/bone volume) and mineral content (SEM, atomic absorption spectrometry).

Main Results:

  • Radiographic fractal dimension values showed proportional variations between maxillary and mandibular molar/premolar regions.
  • Histological bone density was higher in mandibular bone blocks than in maxillary specimens.
  • Preoperative fractal dimension values and trephined bone densities demonstrated statistically similar distributions, with four bone density types classified.

Conclusions:

  • Fractal dimension analysis of preoperative radiographs offers a potentially useful, non-invasive method for predicting bone density at dental implant recipient sites.
  • Caution is advised regarding the type of digital radiograph and region of interest size when using this technique.
  • Histological analysis of harvested bone specimens serves as an absolute reference for validating radiographic findings.