Yemenoglu Hatice, Beder Melek, Cüre Osman, Günaçar Dilara Nil
Department of Periodontology, Faculty of Dentistry, Recep Tayyip Erdoğan University, Rize 53020, Turkey.
Rheumatology Subdivision, Department of Internal Diseases, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize 53020, Turkey.
Diagnostics (Basel). 2025 Jan 28;15(3):306. doi: 10.3390/diagnostics15030306.
To appraise the mandibular bone structure of patients with rheumatoid arthritis (RA) who were treated with different drugs using fractal dimension (FD) analysis and panoramic radiomorphometric indices and investigate the effects of RA on the jaw bone. A total of 90 panoramic radiographs were analyzed in this study: 30 were from patients with RA using conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and glucocorticoids, 30 were from patients with RA using tumor necrosis factor-alpha (TNF-α) inhibitors, and 30 were from systemically healthy individuals. In panoramic radiographs, panoramic mandibular index (PMI), mandibular cortical thickness measurements, mandibular cortical index (MCI), and FD analysis taken from four different regions were evaluated. The lowest FD analysis value was observed in patients using csDMARDs and glucocorticoids and in the condyle region ( = 0.001). Although PMI and posterior index (PI) were found to be significantly lower in patients using csDMARDs and glucocorticoids compared with the others ( = 0.001), no significant difference was observed between the groups in terms of anterior index (AI), symphysis index (SI), and molar index (MI) values ( > 0.05). When MCI was analyzed, there was no significant difference between the groups ( > 0.05). It was observed that the trabecular structure in the condyle and posterior region of the mandible was negatively influenced by RA and csDMARD and glucocorticoid drug use. Radiomorphometric indices and FD analysis on panoramic radiographs can be used to evaluate osteoporotic alterations in individuals with RA. These assessments are valuable in predicting the prognosis of conditions such as bone healing after tooth extraction and other surgical procedures and osseointegration after implant surgery.
使用分形维数（FD）分析和全景放射形态计量学指标评估接受不同药物治疗的类风湿性关节炎（RA）患者的下颌骨结构，并研究RA对颌骨的影响。本研究共分析了90张全景X线片：30张来自使用传统合成抗风湿药物（csDMARDs）和糖皮质激素的RA患者，30张来自使用肿瘤坏死因子-α（TNF-α）抑制剂的RA患者，30张来自全身健康个体。在全景X线片中，评估了全景下颌指数（PMI）、下颌骨皮质厚度测量值、下颌骨皮质指数（MCI）以及取自四个不同区域的FD分析。在使用csDMARDs和糖皮质激素的患者以及髁突区域观察到最低的FD分析值（P = 0.001）。尽管发现使用csDMARDs和糖皮质激素的患者的PMI和后牙指数（PI）明显低于其他患者（P = 0.001），但在两组之间，在前牙指数（AI）、正中联合指数（SI）和磨牙指数（MI）值方面未观察到显著差异（P>0.05）。分析MCI时，组间无显著差异（P>0.05）。观察到下颌骨髁突和后部区域的小梁结构受到RA以及csDMARD和糖皮质激素药物使用的负面影响。全景X线片上的放射形态计量学指标和FD分析可用于评估RA患者的骨质疏松改变。这些评估对于预测拔牙和其他外科手术后的骨愈合以及种植手术后的骨整合等情况的预后具有重要价值。
