Effect of Fixed and Removable Functional Therapy on Mandibular Anterior Bone Structures: A Fractal Analysis Study

Area of Science:

• Orthodontics
• Dental Anthropology
• Biomedical Engineering

Background:

• Functional therapies are widely used in orthodontics to modify dentoalveolar and skeletal structures.
• Investigating the impact of these therapies on bone microstructure is crucial for understanding treatment outcomes.

Purpose of the Study:

• To evaluate changes in mandibular anterior trabecular bone structures using fractal dimension (FD) analysis after fixed and removable functional therapy.
• To assess the relationship between FD and the Incisor Mandibular Plane Angle (IMPA).

Main Methods:

• A retrospective study of 60 patients with Class II malocclusion, divided into a control group (CG), Forsus fatigue-resistant device group (FFRDG), and Monoblock group (MBG).
• Lateral cephalometric radiographs taken before (T0) and after (T1) treatment were analyzed for FD in the buccoapical and symphyseal regions.
• Statistical analysis included parametric and nonparametric tests, with significance set at p < 0.05.

Main Results:

• No significant difference in FD values was observed among groups at T0.
• At T1, buccoapical FD values were significantly lower in the FFRDG and MBG compared to CG (p < 0.05).
• A significant negative correlation was found between IMPA and buccoapical FD in FFRDG and MBG (p < 0.05).

Conclusions:

• Fractal dimension analysis on lateral cephalometric radiographs can effectively evaluate trabecular bone changes from functional therapy.
• Controlled management of IMPA is recommended during functional therapy to mitigate decreases in buccoapical FD caused by incisor movement.