Kumar Sanjana Santhosh, Nagi Ravleen, Chacko Rachel, Khan Junad
Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY, 14610, USA.
Department of Orofacial Pain and TMJ Disorders, Eastman Institute for Oral Health, University of Rochester, 625 Elmwood Avenue, Rochester, NY, 14620, USA.
Oral Radiol. 2025 Apr;41(2):153-168. doi: 10.1007/s11282-024-00791-1. Epub 2024 Dec 9.
This study aims to evaluate the application and effectiveness of fractal analysis (FA) in assessing temporomandibular joint disorders (TMDs) with dental imaging.
This systematic review, conducted in adherence to PRISMA-P and Cochrane Handbook guidelines, involved a comprehensive search of five electronic indexed databases up to September 15, 2024. The thorough search aimed to ensure the inclusion of all relevant studies on dental imaging with fractal dimension (FD) analysis for TMDs. The risk of bias was performed using the revised QUADAS 2 tool.
Out of 342 studies retrieved, 15 met the inclusion criteria and were included in the systematic review. These studies comprised 7 retrospective and 8 prospective nonrandomized clinical studies. Various imaging modalities were used including panoramic, CT, CBCT, and MRI. Most studies reported significantly lower FD values in TMD patients than in controls suggesting FD analysis' potential for detecting early TMJ degenerative changes. However, a few studies did not find significant differences or lacked control groups, highlighting the variability in findings across the research. The overall risk of bias was high regarding the applicability of all included studies.
The fractal dimension (FD) analysis of dental images shows potential as a valuable tool for detecting early degenerative changes in temporomandibular disorders (TMDs). It could enhance diagnostic efficiency by providing additional insights from routine radiographs. However, the variability in findings and methodologies underscores the need for further research to validate and standardize these techniques.
本研究旨在评估分形分析（FA）在牙科影像学评估颞下颌关节紊乱病（TMDs）中的应用及有效性。
本系统评价遵循PRISMA-P和Cochrane手册指南进行，全面检索了截至2024年9月15日的五个电子索引数据库。此次全面检索旨在确保纳入所有关于使用分形维数（FD）分析TMDs的牙科影像学相关研究。使用修订后的QUADAS 2工具进行偏倚风险评估。
在检索到的342项研究中，15项符合纳入标准并被纳入系统评价。这些研究包括7项回顾性研究和8项前瞻性非随机临床研究。使用了多种成像方式，包括全景片、CT、CBCT和MRI。大多数研究报告称，TMD患者的FD值显著低于对照组，这表明FD分析在检测早期颞下颌关节退行性改变方面具有潜力。然而，少数研究未发现显著差异或缺乏对照组，凸显了研究结果的变异性。所有纳入研究的适用性方面的总体偏倚风险较高。
牙科图像的分形维数（FD）分析显示出作为检测颞下颌关节紊乱病（TMDs）早期退行性改变的有价值工具的潜力。它可以通过从常规X线片中提供额外的见解来提高诊断效率。然而，研究结果和方法的变异性强调了进一步研究以验证和规范这些技术的必要性。
