Quintessence Int. 2024 Mar 27;55(3):192-200. doi: 10.3290/j.qi.b4920297.
Fractal analysis is a numerical method that indicates the structural patterns and complexity of the trabecular bone on radiographs. The aim of this cross-sectional study was to evaluate the trabecular bone structure in systemically healthy patients and diabetes mellitus patients with periodontitis using fractal analysis.
The study included 125 mandibular first molars of nonsmoker patients. The subjects were divided into five subgroups: diabetes mellitus patients with mild-moderate periodontitis, diabetes mellitus patients with advanced periodontitis, systemically healthy individuals with mild-moderate periodontitis, systemically healthy individuals with advanced periodontitis, and systemically healthy individuals with gingivitis (control group). Clinical periodontal parameters (pocket depth, bleeding on probing, clinical attachment loss, and bone loss) were recorded. Two specific sites located in the mesial-distal regions (n = 250) of the mandibular first molars were identified using periapical radiographs captured with a parallel technique. Fractal analysis values were calculated using the box-counting method. One-way analysis of variance (ANOVA), and Pearson correlation analysis were used for statistical evaluation.
The highest fractal analysis values were observed in systemically healthy with gingivitis patients (mesial fractal analysis: 1.86 ± 0.01; distal fractal analysis: 1.85 ± 0.01). Patients with periodontitis (mesial fractal analysis: 1.78 ± 0.02; distal fractal analysis: 1.79 ± 0.01) exhibited lower fractal analysis values compared to the control group. There was no significant difference in mesial and distal fractal analysis values between all periodontitis groups. No correlation was found between age, sex, clinical attachment loss, bone loss, and fractal analysis (P > .05).
Although fractal analysis values were lower in the periodontitis groups compared to the control group, fractal analysis did not demonstrate any periodontitis-associated changes of bone trabeculation in diabetes at any stage of periodontitis. Furthermore, there was no significant association between fractal analysis values and age, sex, clinical attachment, and bone loss.
分形分析是一种数值方法，可用于指示 X 光片上的小梁骨结构模式和复杂性。本横断面研究的目的是使用分形分析评估患有牙周炎的系统性健康患者和糖尿病患者的小梁骨结构。
本研究纳入了 125 颗下颌第一磨牙，这些患者均为非吸烟者。研究对象分为五组：轻度-中度牙周炎的糖尿病患者、重度牙周炎的糖尿病患者、轻度-中度牙周炎的系统性健康患者、重度牙周炎的系统性健康患者和有牙龈炎的系统性健康患者（对照组）。记录临床牙周参数（探诊深度、探诊出血、临床附着丧失和骨丧失）。使用平行技术拍摄的根尖片确定下颌第一磨牙近远中区域的两个特定部位（n=250）。使用盒计数法计算分形分析值。采用单因素方差分析（ANOVA）和 Pearson 相关分析进行统计学评价。
有牙龈炎的系统性健康患者的分形分析值最高（近中部位分形分析：1.86±0.01；远中部位分形分析：1.85±0.01）。患有牙周炎的患者（近中部位分形分析：1.78±0.02；远中部位分形分析：1.79±0.01）的分形分析值低于对照组。所有牙周炎组的近中部位和远中部位分形分析值之间无显著差异。年龄、性别、临床附着丧失、骨丧失与分形分析之间均无相关性（P＞0.05）。
尽管与对照组相比，牙周炎组的分形分析值较低，但分形分析并未显示任何阶段牙周炎的糖尿病患者的骨小梁结构发生与牙周炎相关的变化。此外，分形分析值与年龄、性别、临床附着和骨丧失之间无显著关联。
