Sağlıklı Ve Osteoporoz Tanılı Hastalarda Fraktal Boyut Ve Mandibular Kortikal İndeks Değerlendirilmesi

Amaç: Bisfosfonat tedavisi altında olan bireylerin mandibular kemik dokusu değişikliklerini fraktal analiz yöntemi ile saptayıp ve sağlıklı bireylerden elde edilen bulgular ile karşılaştırmaktır. Yöntem: 20 adet sağlıklı 20 adet bisfosfanat tedavisi altında olan hastadan elde edilen görüntüler üzerinde kortikal kalınlık (KK), panoramik mandibular indeks (PMI) ve fraktal boyut (FB) ölçümleri yapıldı. FB ölçümleri, her hastaya ait panoramik görüntü üzerinde 3 farklı alanda (angulus, corpus ve interdental kemik) gerçekleştirildi. İstatistiksel analiz aşamasında ANOVA, Tukey-Kramer testi ve Pearson korelasyon katsayısından yararlanıldı. Bulgular: 2 farklı hasta grubuna ve farklı lokalizasyonlara ait FB değerleri arasında istatistiksel olarak anlamlı bir farklılık saptandı (p=0.0004). İnterdental kemik ve korpus mandibula bölgesin ait FB değerleri arasındaki fark anlamlı iken (p=0.008), diğer 2 farklı lokalizasyona ait değerlerin ikili karşılaştırmalarında anlamlı bir farklılık saptanmadı (p>0.05). 2 farklı hasta grubunun KK ve PMI değerleri arasında anlamlı bir farklılık bulunmadı (p>0.05). KK-PMI( p=0.86) ve KK-FB ( p=0.26) arasında düşük bir korelasyon saptanırken, FB ve PMI arasında negatif bir korelasyon saptandı (p=0.96). Sonuç: Fraktal boyut analizi, bisfosfanat tedavisi altındaki hastaların mandibular kemik dokusu değişikliklerinin ayırımında kullanılabilecek bir yöntemdir. Direkt dijital panoramik sistem kullanılarak elde edilen görüntüler üzerinde interdental kemik ve korpus mandibula bölgesine ait gerçekleştirilen FB ölçümlerinden bisfosfanat kullanan hastaların izlenmeleri aşamasında yararlanılabilir

Fractal Dimension And Mandibular Cortical Bone Index Evaluations In Normal And Osteoporotic Patients

Introduction: To evaluate the radiographic changes of mandibular bone texture in patients receiving bisphosphonate therapy and to compare with healthy controls. Methods: Direct digital panoramic images of twenty healthy individuals and twenty patients under bisphosphonate therapy were used for measurements of mandibular cortical width (CW), panoramic mandibular indices (PMI) and fractal dimension (FD). FD was calculated on three regions of interest on each side of the panoramic images (angulus, corpus and inter-dental bone). Three-way ANOVA, TukeyKramer tests and Pearson’s correlation coefficient were used for comparisons. Results: Significant difference was found in FDs of two groups (p=0.0004) and different locations (p=0.0001). The difference in FDs of inter-dental bone areas and corpus mandible was significant (p=0.008), while no difference was found for pair-wise comparisons of other two locations (p>0.05). No difference could be obtained in CW and PMI of two groups (p>0.05). Weak insignificant correlation was found between CW-FD ( p=0.26) and CW-PMI ( p=0.86) while there was an insignificant negative correlation between FD and PMI (p=0.96). Conclusion: FD is a good discriminator of altered mandibular bone texture of patients under bisphosphonate therapy. FD of inter-dental and corpus mandibular bone areas as calculated on direct digital panoramic images could be reliable in screening patients using bisphosphonates

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