Clinical Dentistry and Research, cilt.48, sa.3, ss.125-132, 2024 (Hakemli Dergi)
Background and Aim: To evaluate if the extent and severity of periodontal bone destruction, as expressed by bone loss in each stage, is reflected in trabecular bone on both digital panoramic and cone beam computed tomography (CBCT) images using the fractal analysis method. Materials and Methods: The present study recruited digital panoramic and CBCT images of mandibular premolar and molar regions. The criteria described in the recent Classification of Periodontal and Peri-Implant Diseases and Conditions (2017) were used to determine the extent of radiographical bone loss. According to this criteria, radiographic bone loss was in line with stage I (N=27), stage II (N=30), stage III (N=27), and no radiographic evidence of bone loss (NBL) as a healthy group (N=29). A region of interest (ROI) was selected to measure fractal dimension (FD) on the radiographic images. Results: In the present study, digital panoramic and CBCT images of 21 teeth in stage I, 23 teeth in stage II, 22 teeth in stage III, and 20 teeth in the NBL group were evaluated. Significant differences were observed between the groups in terms of fractal dimensions calculated on panoramic radiographs (p<0.05), while CBCT-FD values did not differ among the groups (p>0.05). Significantly lower fractal dimensions on panoramic radiographs were measured in stage III than in the other groups (p<0.05). Conclusion: Fractal analysis performed on panoramic radiographs allows for the distinction of advanced periodontal destruction. In this regard, fractal analysis on panoramic radiographs may have additional benefits for detecting the extent of periodontal destruction.