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Assessment of Mandibular Bone Architecture in Patients with Endocrine Disorders Using Fractal Dimension and Histogram
Elif Yıldızer1, Saliha Kubra Sari1, Fatih Peker1
1Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ankara Yildirim Beyazit University, 06010 Ankara, Turkey.
Tomography (Ann Arbor, Mich.)
|June 25, 2025
Summary
Fractal dimension analysis revealed reduced mandibular bone structure in hyperthyroidism but not in diabetes mellitus. This non-invasive method may detect subtle bone changes in endocrine disorders.
Area of Science:
- Endocrinology
- Oral Radiology
- Bone Metabolism
Background:
- Endocrine disorders like diabetes mellitus and thyroid dysfunction affect bone metabolism.
- Mandibular trabecular architecture can be altered by these systemic conditions.
Purpose of the Study:
- To assess mandibular trabecular architecture in patients with type 1 diabetes mellitus (T1DM), type 2 diabetes mellitus (T2DM), hyperthyroidism, and hypothyroidism.
- To compare these findings with a healthy control group using fractal dimension (FD) and histogram analyses (HA).
Main Methods:
- Retrospective analysis of panoramic radiographs from 200 individuals (40 per group: T1DM, T2DM, hyperthyroidism, hypothyroidism, and controls).
- Fractal dimension and histogram-based pixel intensity analyses performed on standardized regions of interest (ROI) of the right mandible using ImageJ software.
- Statistical comparisons included ANOVA, t-test, Mann-Whitney U, and Spearman correlation analyses.
Main Results:
- No significant differences in age or gender distributions across groups.
- A significant reduction in FD was observed in the hyperthyroidism group compared to controls at ROI1 (p = 0.018).
- No other significant FD differences were found among diabetic groups or other ROIs; pixel intensity values did not differ significantly across groups.
Conclusions:
- FD analysis may serve as a non-invasive tool for detecting subtle mandibular bone alterations, particularly in hyperthyroidism.
- No significant impact on mandibular trabecular architecture was detected in diabetic patients within this study.
- Further research with larger cohorts and detailed biochemical data is recommended to validate these findings.
